3D-printed Polyetheretherketone Research Articles

Comprehensive analysis of fused deposition modeling process conditions for enhancing mechanical properties and surface quality of 3D-Printed poly-ether-ether-ketone

Fused deposition modeling (FDM) technology is a convenient manufacturing approach for poly-ether-ether-ketone (PEEK) components. In this study, a comprehensive study of the influence of FDM process parameters on the mechanical property and surface quality of 3D-printed PEEK printed with different directions was carried out. The results show that crystallinity of PEEK materials and the pores/gaps between the printing filaments jointly affect the mechanical properties and surface quality of PEEK structural parts. Then, material-structure-property linkage mechanism was revealed. Through the research conducted, crucial processing parameters to enhance the mechanical properties and surface quality of PEEK samples was determined. High tensile strength (91.75 MPa, which was close to the performance of injection molded components) and surface quality (Ra 7.9 μm) was obtained by regulation the nozzle temperature and annealing temperature to improve the crystallinity. Meanwhile, tensile strength of z-Sample was increased from 7.36 MPa to 18.30 MPa (with an increase of 148.64%). High Young's modulus (3.09 GPa) and large plastic strain (exceed 13.91%) was achieved by regulation the nozzle temperature and printing speed to reduce the porosity between PEEK filaments.

Exploring the mechanical strength, antimicrobial performance, and bioactivity of 3D-printed silicon nitride-PEEK composites in cervical spinal cages

 In this study, our goal was to assess the suitability of a polyether-ether-ketone (PEEK) and silicon nitride (Si3N4) polymer composite for antimicrobial three-dimensional (3D)-printed cervical cages. Generic cage designs (PEEK and 15 vol.% Si3N4-PEEK) were 3D-printed, including solid and porous cage designs. Cages were tested in static compression, compression shear, and torsion per ASTM F2077. For antibacterial testing, virgin and composite filament samples were inoculated with Staphylococcus epidermidis and Escherichia coli. In vitro cell testing was conducted using MC3T3-E1 mouse preosteoblasts, where cell proliferation, cumulative mineralization, and osteogenic activity were measured. The 3D-printed PEEK and Si3N4-PEEK cages exhibited adequate mechanical strength for all designs, exceeding 14.7 kN in compression and 6.9 kN in compression shear. Si3N4-PEEK exhibited significantly lower bacterial adhesion levels, with a 93.9% reduction (1.21 log), and enhanced cell proliferation when compared to PEEK. Si3N4-PEEK would allow for custom fabrication of 3D-printed spinal implants that reduce the risk of infection compared to unfilled PEEK or metallic alloys.  

Sand casting-inspired surface modification of 3D-printed porous polyetheretherketone scaffolds for enhancing osteogenesis

3D-printed polyetheretherketone (PEEK) scaffolds are developed as novel bone substitutes, however, their bioinert surface hinders osteogenesis and modifying PEEK scaffolds without blocking their inter-connected porous structure is challenged. In this study, 45S5 bioactive glasses (BG) were homogeneously coated on PEEK scaffolds inspired by traditional sand-casting. The structure of PEEK scaffolds was preserved under shaping effect of BG fillers. Modulus, coating yield and hydrophilicity of scaffolds after different thermal treatment time were comparatively investigated. Excellent hydroxyapatite-forming ability of BG-coated scaffolds was confirmed by mineralization study. In-vitro assessments, BG-coated scaffolds cultured with MC3T3-E1 cells presented potential as bone implants with excellent cytocompatibility and osteogenic properties. Following similar coating strategy, conductive particles, multi-component particles and template particles were also coated on PEEK surface. The proposed methodology highlights a useful approach towards producing tunable biomedical coatings and microstructure on porous PEEK scaffolds for bone tissue engineering.

Management of severe defects of humerus in combat patients injured in Russo-Ukrainian war

IntroductionRusso-Ukrainian war is associated with application of high-energy weapon, causing severe multifragmental injuries to the bones an associating with severe bone defects.The aim of the study was to evaluate various methods to treat combat patients with severe defects of humerus and to demonstrate the experience of orthopedic war surgeons in managing gunshot injuries to the humerus defects in the ongoing war. Patients and methodsA 24 patients were active-duty military personnel of Armed Forces of Ukraine. These patients were diagnosed with severe humerus defects due to gunshot injury in battlefield zone in various areas of Ukraine. Data was collected within period between February, 24th 2022 till January, 01st 2023. The following approaches were applied to replace bone defect: preoperative 3D printing with polyetheretherketone (PEEK) as orthobiological material; closed reduction, percutaneous lag screw and Ilizarov external fixation; vascularized fibula grafting. ResultsData analyses of the segmental defects of humerus showed 5 cm defect in 3 (13 %) patients, from 5 to 10 cm in 4 (17 %) patients, over 10 cm in 17 (71 %) patients. Analyses were performed in these 17 (71 %) patients, showing 5 patients treated with 3D-printed PEEK implants, 6 patients with vascular-pedicle graft of fibula, 6 patients with closed reduction, percutaneous lag screw, Ilizarov external fixation. Osteomyelitis was diagnosed in one case (20 %) after the use of PEEK implants, requiring to remove both PEEK implant and metal implants followed by application of the antibiotic joint spacers and Ex-Fix fragments of the humerus. In our opinion, the osteomyelitis happened due to inadequate debridement of the wound and non-compliance with the conversion criteria (replacement of the fixation method). The mean length of hospital stay was 5.5 months for patients treated with 3D-printed PEEK implants. ConclusionsClosed reduction, percutaneous lag screw and Ilizarov external fixation as well as vascularized fibula grafting are associated with good outcomes in management of the patients with severe humerus defect due to gunshot injury. 3D printing and PEEK implants could also be considered for the reconstructions of the humerus multifragmental fractures with a bone defect over 10 cm associated with gunshot injury due to high-energy weapon in the war settings.

High-Cycle Fatigue Behaviour of Polyetheretherketone (PEEK) Produced by Additive Manufacturing.

Polyetheretherketone (PEEK) is the leading high-performance thermoplastic biomaterial that can be processed through material extrusion (ME) additive manufacturing (AM), also known as three-dimensional (3D) printing, for patient-specific load-bearing implant manufacture. Considering the importance of cyclic loading for load-bearing implant design, this work addresses the high-cycle fatigue behaviour of 3D-printed PEEK. In this work, printed PEEK specimens are cyclically loaded under stress-controlled tension-tension using different stress levels between 75% and 95% of printed PEEK's tensile strength. The experimental results are used to document 3D-printed PEEK's fatigue behaviour using Basquin's power law, which was compared with previous fatigue research on bulk PEEK and other 3D-printing materials. As a pioneering study on its fatigue behaviour, the results from this work show that 3D-printed PEEK exhibits an above-average fatigue strength of 65 MPa, corresponding to about 75% of its tensile strength. Fracture surface analysis suggests that a transition can occur from ductile to brittle fracture with maximum stresses between 85% and 95% of the tensile strength. Evidence of crack propagation features on fracture surfaces under scanning electron microscope (SEM) observation suggests crack initiation in void defects created by printing deposition that propagates longitudinally through line bonding interfaces along layers. Considering this, 3D-printed PEEK's fatigue behaviour can be strongly related to printing conditions. Further research on the fatigue behaviour of 3D-printed PEEK is necessary to support its use in load-bearing implant applications.

Experimental Analysis of Crystallinity and Mechanical Properties for Fused Filament Printed Polyetherketone Composites

The objective of this article is to examine the impacts of molybdenum disulphide (MoS2) and graphite-filled (Gr) polyetheretherketone (PEEK) composites that have been fabricated through 3D printing on their mechanical properties and crystallinity. Seven samples and thirty-five dog bones were produced using different filament strands to conduct the analysis. Before extrusion into filaments, the solid lubricants, MoS2, and graphite were uniformly dispersed within the PEEK through mechanical blending. At a concentration of 10 wt.%, the PEEK/MoS2 composites exhibited the highest tensile strength, measuring approximately 104 MPa, while the PEEK/Gr composites displayed the lowest tensile strength at the same concentration, approximately 36 MPa. In addition, the PEEK/MoS2 composites demonstrated better elongation, approximately 4.7%, compared to the PEEK/Gr composites, which exhibited approximately 2.3% elongation. X-ray diffraction (XRD) data revealed that neither MoS2 nor graphite significantly interacted with the PEEK matrix. The degree of crystallinity, as determined by density matrices, indicated that the printed PEEK composites possessed a higher level of crystallinity, approximately 62% at a concentration of 5 wt.%, than the calculated values. This suggests that the filament-making and 3D printing processes had an annealing effect. The significance of solid lubricant content and dispersion in shaping the mechanical properties and crystal formation of 3D-printed PEEK composites is emphasized in this study. Furthermore, this research provides valuable insights for optimizing PEEK-based materials for various applications.

Determining the effect of porosities on the hydrogen adsorption capacity of 3D printed PEEK

In this investigation, as one of the most common polymer-based materials, polyether-ether-ketone (PEEK) was chosen to study its hydrogen adsorption capacity. The shape and size of porosities control the specific surface area and possible sites of hydrogen adsorption. Therefore, the FDM 3D printing method was utilized to fabricate the PEEK sample with different porosity sizes, and the effect of variation of the process parameters (nozzle temperature and nozzle speed) on the shape and size of porosities and finally, the hydrogen adsorption capacity was evaluated. The effect of the variation of the nozzle temperature on the heat distribution was simulated using COMSOL Multiphysics. The results of the heat temperature distribution exhibited that the shape of the porosities will be differed due to the solidification shrinkage caused by the temperature gradients in the middle areas of the 3D-printed PEEK samples, which was subsequently confirmed by optical microscopy and X-ray Computed Tomography (XCT). Porosities can be classified into three main groups including mesopores, mesopores and macropores. Additionally, 3D printed parts have the porous structure and by designing a porous structure by CAD software, the formation of the macropores and subsequently meso-and micropores is passivated, which can be detected through the XCT results. Consequently, these pores increased the surface area and provide more site for hydrogen adsorption. XCT was carried out, and the results showed the formation of the closed pores, which was decreased by increasing the nozzle temperature due to the presence of the melted filament from 0.64 to 0.19%. The hydrogen adsorption capacity was studied through electrochemical analysis methods including cyclic voltammetry, charge/discharge, and electrochemical impedance spectroscopy. Results showed that the sample was printed with a nozzle temperature of 375 °C and nozzle speed of 30 mm s−1, illustrating the highest electrochemical hydrogen adsorption capacity of 2.66 mAh.g−1, which can be related to the activation of the capillary force and new available sites in the interface of the electrolyte and 3D-printed electrode.

Computational assessment of effect of porosity on thermal conductivity of 3D-printed PEEK/carbon-fiber composite

The three-dimensional (3D) printing of polymer matrix composites has attracted considerable attention. However, the addition of filler materials to the extruded polymer matrix results in inner voids within the beads along with larger voids, called intervoids, which are generated between the beads during the 3D printing process. These voids degrade the thermal transport properties of 3D-printed polyether ether ketone (PEEK) and PEEK/carbon-fiber composites. The effects of these pores (i.e., their number, size, and location) on the thermal conductivity of 3D-printed PEEK and a PEEK/carbon-fiber composite were investigated using a multiscale finite element approach. The presence of the carbon fibers mitigated the effect of the pores on the thermal conductivity of the PEEK/carbon-fiber composite, particularly along the longitudinal direction. Moreover, the inner voids had a dominant effect on the PEEK and PEEK/carbon-fiber composite. Finally, the orientation of the intervoids had no effect on the thermal conductivity of the printed materials.

Feasibility of 3D-Printed Locking Compression Plates with Polyether Ether Ketone (PEEK) in Tibial Comminuted Diaphyseal Fractures.

The applicability of a polyether ether ketone locking compression plate (PEEK LCP) fabricated using FDM (fused deposition modeling)-based 3D printing to treat actual patients was studied. Three different tests-bending, axial compression, and axial torsion-were conducted on tibial non-osteoporotic comminuted diaphyseal fracture samples fixed with the commercial titanium alloy LCP and 3D-printed PEEK LCP. Comparing the outcomes of these tests revealed that the commercial titanium alloy LCP underwent plastic deformation in the bending and axial torsion tests, though the LCP did not fail even when an external force greater than the maximum allowable load of the tibia fixture of the LCP was applied. Elastic deformation occurred in the 3D-printed PEEK LCP in the bending and axial torsion tests. However, deformation occurred even under a small external force, and its stiffness was 10% compared to commercial titanium alloy LCP. Thus, 3D-printed PEEK LCP can be applied to the fracture conditions in non-weight-bearing regions. The experimental results reveal detailed insights into the treatment of actual patients by considering the stiffness and high toughness of 3D-printed PEEK LCP.

A comprehensive mechanical characterization of as-printed and saliva soaked 3D printed PEEK specimens for low-cost dental implant applications

Dental implants play an important role in the reconstruction of the lost tooth. The implant materials and manufacturing techniques are of significant importance in the performance of the implants. Conventional dental implant materials such as titanium and zirconia exhibit many limitations such as allergies, peri-implant bone loss, and implant fractures. Implant fractures are caused due to stress shielding arising from the significant difference in mechanical properties between the implant and jawbone. However, polymeric materials can overcome the limitations of metallic implant materials. In this work, Polyether ether ketone (PEEK) specimens are manufactured using the fused deposition molding (FDM) technique, and the effect of printing parameters on its mechanical properties are investigated for dental implant applications. Three different raster angles, (0°/0°), (45°/−45°), and (90°/90°), were considered, and an array of mechanical characterizations are performed on the printed specimens to find tensile, compression, flexural, hardness, and saliva absorption properties for as-printed and saliva soaked conditions. 3D-printed PEEK specimens with a (45°/−45°) raster angle displayed a superior mechanical properties compared to other raster angle specimens. Results showed that 3D printed PEEK exhibits similar properties to natural human tooth enamel, while extruded PEEK exhibits characteristics similar to natural dentin and cortical bone. The 3D printed PEEK crown's potential to withstand compressive loads during biting (∼50 N) was also evaluated and found that the PEEK has adequate mechanical properties to be a better low-cost implant material than titanium and zirconium.

Customed 3D-printed Polyetheretherketone (PEEK) Implant for Secondary Salvage Reconstruction of Mandibular Defects: Case Report and Literature Review.

Given the insufficient height of single-barrel fibula and inadequate bone volume of double-barrel vascularized fibula in mandibular reconstruction, it is a better choice to combine the upper full-thickness vascularized fibula with the lower half-thickness nonvascularized fibula. However, the nonvascularized fibula may fail due to complications, affecting the facial shape and occlusal function. Polyetheretherketone is a thermoplastic polymer used for bone defect reconstruction due to its good mechanical properties and biocompatibility. This case report mainly presents a secondary salvage reconstruction of the mandible by using customed 3-dimensional-printing polyetheretherketone, which restored the continuity and symmetry of the mandible, improved the patient's facial shape, and restored functional occlusion through dental implants. After a 28-month follow-up, no complications occurred, and the patient was satisfied with the final restoration.

Fabrication of polyetheretherketone (PEEK)-based 3D electronics with fine resolution by a hydrophobic treatment assisted hybrid additive manufacturing method

Additive manufacturing (AM) is a free-form technology that shows great potential in the integrated creation of three-dimensional (3D) electronics. However, the fabrication of 3D conformal circuits that fulfill the requirements of high service temperature, high conductivity and high resolution remains a challenge. In this paper, a hybrid AM method combining the fused deposition modeling (FDM) and hydrophobic treatment assisted laser activation metallization (LAM) was proposed for manufacturing the polyetheretherketone (PEEK)-based 3D electronics, by which the conformal copper patterns were deposited on the 3D-printed PEEK parts, and the adhesion between them reached the 5B high level. Moreover, the 3D components could support the thermal cycling test from −55 °C to 125 °C for more than 100 cycles. Particularly, the application of a hydrophobic coating on the FDM-printed PEEK before LAM can promote an ideal catalytic selectivity on its surface, not affected by the inevitable printing borders and pores in the FDM-printed parts, then making the resolution of the electroless plated copper lines improved significantly. In consequence, Cu lines with width and spacing of only 60 µm and 100 µm were obtained on both as-printed and after-polished PEEK substrates. Finally, the potential of this technique to fabricate 3D conformal electronics was demonstrated.

Strategies for the Covalent Anchoring of a BMP-2-Mimetic Peptide to PEEK Surface for Bone Tissue Engineering.

Researchers in the field of tissue engineering are always searching for new scaffolds for bone repair. Polyetheretherketone (PEEK) is a chemically inert polymer that is insoluble in conventional solvents. PEEK's great potential in tissue engineering applications arises from its ability to not induce adverse reactions when in contact with biological tissues and its mechanical properties, which are similar to those of human bone. These exceptional features are limited by the bio-inertness of PEEK, which causes poor osteogenesis on the implant surface. Here, we demonstrated that the covalent grafting of the sequence (48-69) mapped on the BMP-2 growth factor (GBMP1α) significantly enhances the mineralization and gene expression of human osteoblasts. Different chemical methods were employed for covalently grafting the peptide onto 3D-printed PEEK disks: (a) the reaction between PEEK carbonyls and amino-oxy groups inserted in the peptides' N-terminal sites (oxime chemistry) and (b) the photoactivation of azido groups present in the peptides' N-terminal sites, which produces nitrene radicals able to react with PEEK surface. The peptide-induced PEEK surface modification was assessed using X-ray photoelectron measurements, while the superficial properties of the functionalized material were analyzed by means of atomic force microscopy and force spectroscopy. Live and dead assays and SEM measurements showed greater cell cover on functionalized samples than the control, without any cytotoxicity induction. Moreover, functionalization improved the rate of cell proliferation and the amount of calcium deposits, as demonstrated by the AlamarBlue™ and alizarin red results, respectively. The effects of GBMP1α on h-osteoblast gene expression were assayed using quantitative real-time polymerase chain reaction.

Preparation of Ta2O5/ polyetheretherketone samples with loading of PLGA/antibiotic agents for the tests of antibacterial performances and cell growth activities

BackgroundWith fast increasing of population and the lifetime of human, the possibility of orthopedic disease taking place in elder patients increases, which may make large demands for the application of heterogeneous biomaterials during the clinical treatments. Therefore, high-safety, good antibacterial properties and low cell toxicities for these orthopedic biomaterials are thus necessary. MethodThe 3D-printed polyetheretherketone (PEEK)/tantalum pentoxide (Ta2O5) samples with various film thicknesses were prepared using thermal evaporation method. In order to improve their antibacterial properties, samples with coating of poly (D,L-lactide-co-gycolide, PLGA)/antibiotic agents were prepared. Significant findingsX-ray diffraction pattern, energy-dispersive spectra and fourier-transform infrared spectroscopy of samples revealed that the film deposited onto the PEEK disk was the amorphous Ta2O5. Samples with coating of mixture containing Ampicillin/Vancomycin/PLGA can maintain the suitable antibacterial performances within time interval of 25–28 days. In vitro cytocompatibility test results showed that samples with loading of antibiotic agents/PLGA did not cause the cell cytotoxicity and also maintained good antibacterial performances and may have further applications in the biomedical related technology.

Design, Analysis, and 3D Printing of a Patient-Specific Polyetheretherketone Implant for the Reconstruction of Zygomatic Deformities.

The reconstruction of craniomaxillofacial deformities, especially zygomatic bone repair, can be exigent due to the complex anatomical structure and the sensitivity of the crucial organs involved. The need to reconstruct the zygomatic bone in the most precise way is of crucial importance for enhancing the patient outcomes and health care-related quality of life (HRQL). Autogenous bone grafts, despite being the gold standard, do not match bone forms, have limited donor sites and bone volume, and can induce substantial surgical site morbidity, which may lead to adverse outcomes. The goal of this study is to provide an integrated approach that includes various processes, from patient scanning to implant manufacture, for the restoration of zygomatic bone abnormalities utilizing Polyetheretherketone (PEEK) material, while retaining adequate aesthetic and facial symmetry. This study takes an integrated approach, including computer-aided implant design using the mirror reconstruction technique, investigating the biomechanical behavior of the implant under loading conditions, and carrying out a fitting accuracy analysis of the PEEK implant fabricated using state-of-the-art additive manufacturing technology. The findings of the biomechanical analysis results reveal the largest stress of approximately 0.89 MPa, which is relatively low in contrast to the material's yield strength and tensile strength. A high degree of sturdiness in the implant design is provided by the maximum value of strain and deformation, which is also relatively low at roughly 2.2 × 10-4 and 14 µm. This emphasizes the implant's capability for load resistance and safety under heavy loading. The 3D-printed PEEK implant observed a maximum deviation of 0.4810 mm in the outside direction, suggesting that the aesthetic result or the fitting precision is adequate. The 3D-printed PEEK implant has the potential to supplant the zygoma bone in cases of severe zygomatic reconstructive deformities, while improving the fit, stability, and strength of the implant.

Bioactive PEEK: Surface Enrichment of Vitronectin-Derived Adhesive Peptides.

Polyetheretherketone (PEEK) is a thermoplastic polymer that has been recently employed for bone tissue engineering as a result of its biocompatibility and mechanical properties being comparable to human bone. PEEK, however, is a bio-inert material and, when implanted, does not interact with the host tissues, resulting in poor integration. In this work, the surfaces of 3D-printed PEEK disks were functionalized with: (i) an adhesive peptide reproducing [351-359] h-Vitronectin sequence (HVP) and (ii) HVP retro-inverted dimer (D2HVP), that combines the bioactivity of the native sequence (HVP) with the stability toward proteolytic degradation. Both sequences were designed to be anchored to the polymer surface through specific covalent bonds via oxime chemistry. All functionalized PEEK samples were characterized by Water Contact Angle (WCA) measurements, Atomic Force Microscopy (AFM), and X-ray Photoelectron Spectroscopy (XPS) to confirm the peptide enrichment. The biological results showed that both peptides were able to increase cell proliferation at 3 and 21 days. D2HVP functionalized PEEK resulted in an enhanced proliferation across all time points investigated with higher calcium deposition and more elongated cell morphology.

Effect of Printing Parameters on Mechanical Performance of Material-Extrusion 3D-Printed PEEK Specimens at the Point-of-Care

Additive manufacturing (AM) of polyetheretherketone (PEEK) biomaterials using the material-extrusion (MEX) method has been studied for years. Because of the challenging manufacturing process, precisely controlling printing parameters is crucial. This study aimed to investigate the effects of printing parameters such as orientation and position of printing on mechanical properties. Thus, 34 samples were printed using PEEK filament and the MEX process. Samples were divided into two main groups (A,B) according to their printing orientations (A: groups 1–3) and positions on the build plate (B: groups 4–8). Mechanical tensile tests were performed to evaluate the effects of different printing orientations and positions on mechanical properties. The means of the tensile modulus in samples 3D-printed in XY (group 1), XZ (group 2), and ZX (group 3) orientations were not significantly different (p-value = 0.063). Groups 1 and 2 had smaller distributions than group 3 in the means of tensile strength. The t-test showed that the overall means of the measurements in groups 4–8 did not differ significantly (p-value = 0.315). The tensile tests indicated that printing in vertical and horizontal orientations had no significant influence on mechanical properties. There were no significant differences in mechanical strength between top/bottom printed samples in five different lateral positions. Reliability of printing with good mechanical properties could be a step forward to manufacturing patient-specific implants.

PEEK for Oral Applications: Recent Advances in Mechanical and Adhesive Properties.

Polyetheretherketone (PEEK) is a thermoplastic material widely used in engineering applications due to its good biomechanical properties and high temperature stability. Compared to traditional metal and ceramic dental materials, PEEK dental implants exhibit less stress shielding, thus better matching the mechanical properties of bone. As a promising medical material, PEEK can be used as implant abutments, removable and fixed prostheses, and maxillofacial prostheses. It can be blended with materials such as fibers and ceramics to improve its mechanical strength for better clinical dental applications. Compared to conventional pressed and CAD/CAM milling fabrication, 3D-printed PEEK exhibits excellent flexural and tensile strength and parameters such as printing temperature and speed can affect its mechanical properties. However, the bioinert nature of PEEK can make adhesive bonding difficult. The bond strength can be improved by roughening or introducing functional groups on the PEEK surface by sandblasting, acid etching, plasma treatment, laser treatment, and adhesive systems. This paper provides a comprehensive overview of the research progress on the mechanical properties of PEEK for dental applications in the context of specific applications, composites, and their preparation processes. In addition, the research on the adhesive properties of PEEK over the past few years is highlighted. Thus, this review aims to build a conceptual and practical toolkit for the study of the mechanical and adhesive properties of PEEK materials. More importantly, it provides a rationale and a general new basis for the application of PEEK in the dental field.

Self-Monitoring Performance of 3D-Printed Poly-Ether-Ether-Ketone Carbon Nanotube Composites

In this paper, poly-ether-ether-ketone (PEEK) carbon-nanotube (CNT) self-monitoring composites at different levels of filler loading (i.e., 3, 5 and 10% by weight) have been extruded as 3D-printable filaments, showing gauge factor values of 14.5, 3.36 and 1.99, respectively. CNT composite filaments of 3 and 5 wt% were 3D-printed into tensile samples, while the PEEK 10CNT filament was found to be barely printable. The 3D-printed PEEK 3CNT and PEEK 5CNT composites presented piezo-resistive behavior, with an increase in electrical resistance under mechanical stress, and showed an average gauge factor of 4.46 and 2.03, respectively. Mechanical tests highlighted that 3D-printed samples have a laminate-like behavior, presenting ultimate tensile strength that is always higher than 60 MPa, hence they offer the possibility to detect damages in an orthogonal direction to the applied load wit high sensitivity.

Mechanical performance and bioactivation of 3D-printed PEEK for high-performance implant manufacture: a review.

Polyetheretherketone (PEEK) has stood out as the leading high-performance thermoplastic for the replacement of metals in orthopaedic, trauma and spinal implant applications due to its high biocompatibility and mechanical properties. Despite its potential for custom-made medical devices, 3D-printed PEEK's mechanical performance depends on processing parameters and its bioinertness may hinder bone opposition to the implant. Concerning these challenges, this review focuses on the available literature addressing the improvement of themechanical performance of PEEK processed through "fused filament fabrication" (FFF) along with literature on bioactivation of PEEK for improved osseointegration. The reviewed research suggests that improvements can be achieved in mechanical performance of 3D-printed PEEK with adequate FFF parametrization while different bioactivation techniques can be used to improve the bioperformance of 3D-printed PEEK. The adequate approaches towards these procedures can increase PEEK's potential for the manufacture of high-performance custom-made implantable devices that display improved bone-implant integration and prevent stress shielding of the treated bone.