Top

Clinical Oral Investigations

Published in:

Open Access 17-10-2023 | Laser | Research

Nano-topographical surface engineering for enhancing bioactivity of PEEK implants (in vitro—histomorphometric study)

Authors: Dawlat Mostafa, Youssef M. Kassem, Samia Soliman Omar, Yousreya Shalaby

Published in: Clinical Oral Investigations | Issue 11/2023

Abstract

Objectives

Dental implants are currently becoming a routine treatment decision in dentistry. Synthetic polyetheretherketone (PEEK) polymer is a prevalent component of dental implantology field. The current study aimed to assess the influence of Nd:YAG laser nano-topographical surface engineering combined with ultraviolet light or platelet rich fibrin on the bioactivity and osseointegration of PEEK implants in laboratory and animal testing model.

Materials and methods

Computer Aided Design-Computer Aided Manufacturing (CAD CAM) discs of PEEK were used to fabricate PEEK discs (8 mm × 3 mm) N = 36 and implant cylinders (3 mm × 6 mm) N = 72. Specimens were exposed to Nd:YAG laser at wavelength 1064 nm, and surface roughness topography/Ra parameter was recorded in nanometer using atomic force microscopy. Laser modified specimens were divided into three groups: Nd:YAG laser engineered surfaces (control), Nd:YAG laser/UV engineered surfaces and Nd:YAG laser/PRF engineered surfaces (N = 12 discs–N = 24 implants). In vitro bioactivity test was performed, and precipitated apatite minerals were assessed with X-ray diffraction analysis (XRD) and scanning electron microscopy (SEM). In vivo histomorphometric analysis was performed in rabbits with BIC% calculation.

Results

Ra mean value of PEEK laser engineered surfaces was 125.179 nm. For the studied groups, XRD patterns revealed distinctive peaks of different apatite minerals that were demonstrated by SEM as dispersed surface aggregations. There was a significant increase in the BIC% from control group 56.43 (0.97) to laser/UV surfaces 77.30 (0.78) to laser/PRF 84.80 (1.29) (< 0.0001).

Conclusions

Successful engineered nano-topographical biomimetic PEEK implant could be achieved by Nd:YAG laser technique associated with improving bioactivity. The combination with UV or PRF could be simple and economic methods to gain more significant improvement of PEEK implant surface bioactivity with superior osteointegration.

Available only for authorised users

Jemat A, Ghazali MJ, Razali M, Otsuka Y (2015) Surface modifications and their effects on titanium dental implants. Biomed Res Int 2015:11

Velasco-Ortega E, Jos A, Cameán AM, Pato-Mourelo J, Segura-Egea JJ (2010) In vitro evaluation of cytotoxicity and genotoxicity of a commercial titanium alloy for dental implantology. Mutat Res - Genet Toxicol Environ Mutagen 702(1):17–23

Javed F, Al-Hezaimi K, Almas K, Romanos GE (2013) Is Titanium sensitivity associated with allergic reactions in patients with dental implants? A systematic review. Clin Implant Dent Relat Res 15(1):47–52PubMed

Ikman M, Daud R, Fazliah SN, Khor CY, Roslan H (2022) Assessment of stress shielding around a dental implant for variation of implant stiffness and parafunctional loading using finite element analysis. Acta Bioeng Biomech 24(3):147–159

Aydin C, Yilmaz H, Bankoǧlu M (2013) A single-tooth, two-piece zirconia implant located in the anterior maxilla: a clinical report. J Prosthet Dent 109(2):70–74PubMed

Andreiotelli M, Wenz HJ, Kohal RJ (2009) Are ceramic implants a viable alternative to titanium implants? A systematic literature review. Clin Oral Implants Res 20(SUPPL. 4):32–47PubMed

Li Q, Zhang Y, Wang D, Wang H, He G (2017) Porous polyether ether ketone: a candidate for hard tissue implant materials. Mater Des 116:171–175

Panayotov IV, Orti V, Cuisinier F, Yachouh J (2016) Polyetheretherketone (PEEK) for medical applications. J Mater Sci Mater Med 27(7):1–11

Kurtz SM, Devine JN (2007) PEEK biomaterials in trauma, orthopedic, and spinal implants. Biomaterials 28(32):4845–69PubMedPubMedCentral

10.

Moon SM, Ingalhalikar A, Highsmith JM, Vaccaro AR (2009) Biomechanical rigidity of an all-polyetheretherketone anterior thoracolumbar spinal reconstruction construct: an in vitro corpectomy model. Spine J 9(4):330–335PubMed

11.

Barkarmo S, Wennerberg A, Hoffman M, Kjellin P, Breding K, Handa P et al (2013) Nano-hydroxyapatite-coated PEEK implants: a pilot study in rabbit bone. J Biomed Mater Res - Part A 101 A(2):465–71

12.

Dworak M, Rudawski A, Markowski J, Blazewicz S (2017) Dynamic mechanical properties of carbon fibre-reinforced PEEK composites in simulated body-fluid. Compos Struct 161:428–434

13.

Yuan B, Cheng Q, Zhao R, Zhu X, Yang X, Yang X et al (2018) Comparison of osteointegration property between PEKK and PEEK: effects of surface structure and chemistry. Biomaterials 170:116–126PubMed

14.

Rupp F, Liang L, Geis-Gerstorfer J, Scheideler L, Hüttig F (2018) Surface characteristics of dental implants: a review. Dent Mater 34(1):40–57PubMed

15.

Bral A, Mommaerts MY (2016) In vivo biofunctionalization of titanium patient-specific implants with nano hydroxyapatite and other nano calcium phosphate coatings: a systematic review. J Cranio-Maxillofacial Surg 44(4):400–412

16.

Abdulkareem EH, Memarzadeh K, Allaker RP, Huang J, Pratten J, Spratt D (2015) Anti-biofilm activity of zinc oxide and hydroxyapatite nanoparticles as dental implant coating materials. J Dent. 43(12):1462–9PubMed

17.

Rydén L, Omar O, Johansson A, Jimbo R, Palmquist A, Thomsen P (2017) Inflammatory cell response to ultra-thin amorphous and crystalline hydroxyapatite surfaces. J Mater Sci Mater Med. 28(1):9PubMed

18.

Dufils J, Faverjon F, Héau C, Donnet C, Benayoun S, Valette S (2017) Combination of laser surface texturing and DLC coating on PEEK for enhanced tribological properties. Surf Coatings Technol 329:29–41

19.

Carvalho A, Grenho L, Fernandes MH, Daskalova A, Trifonov A, Buchvarov I et al (2020) Femtosecond laser microstructuring of alumina toughened zirconia for surface functionalization of dental implants. Ceram Int 46(2):1383–1389

20.

Ji M, Xu J, Chen M, El Mansori M (2020) Enhanced hydrophilicity and tribological behavior of dental zirconia ceramics based on picosecond laser surface texturing. Ceram Int 46(6):7161–7169

21.

Yeo I-SL (2020) Modifications of dental implant surfaces at the micro-and nano-level for enhanced osseointegration. Materials (Basel) 13(1):89

22.

Dini C, Nagay BE, Cordeiro JM, da Cruz NC, Rangel EC, Ricomini-Filho AP et al (2020) UV-photofunctionalization of a biomimetic coating for dental implants application. Mater Sci Eng C 110:110657

23.

Funato A, Yamada M, Ogawa T (2013) Success rate, healing time, and implant stability of photofunctionalized dental implants. Int J Oral Maxillofac Implants 28(5):1261–1271PubMed

24.

Lee C, Jeong S-M, Yang H-W, Choi B-H (2020) Effect of ultraviolet irradiation on osseointegration of dental implants: a comparative histomorphometric study in canine models. Appl Sci 10(12):4216

25.

Taniyama T, Saruta J, Rezaei NM, Nakhaei K, Ghassemi A, Hirota M et al (2020) UV-Photofunctionalization of titanium promotes mechanical anchorage in a rat osteoporosis model. Int J Mol Sci 21:1235PubMedPubMedCentral

26.

Borie E, Oliví DG, Orsi IA, Garlet K, Weber B, Beltrán V et al (2015) Platelet-rich fibrin application in dentistry: a literature review. Int J Clin Exp Med 8(5):7922–7929PubMedPubMedCentral

27.

Öncü E, Bayram B, Kantarcı A, Gülsever S, Alaaddinoğlu EE (2016) Positive effect of platelet rich fibrin on osseointegration. Med Oral Patol Oral Cir Bucal 21(5):e601–e607PubMedPubMedCentral

28.

Kokubo T, Takadama H (2006) How useful is SBF in predicting in vivo bone bioactivity? Biomaterials 27(15):2907–2915PubMed

29.

Ahmed DM, Omar SS (2018) Cementing line configuration of bioactive engineered zirconia implants (in vivo histological study). Key Engineering Materials. 786:236–47

30.

Smith MM (1993) Orban oral histology and embryology: 11th edn. Pp. 478. 1991. SN Baskhar. London, Wolfe Publishing. Hardback,£ 29.95. Elsevier

31.

Mostafa D, Aboushelib M (2018) Bioactive–hybrid–zirconia implant surface for enhancing osseointegration: an in vivo study. Int J Implant Dent 4(1):1–7

32.

Durham JW III, Rabiei A (2016) Deposition, heat treatment and characterization of two layer bioactive coatings on cylindrical PEEK. Surf coatings Technol 301:106–113

33.

Ma R, Tang T (2014) Current strategies to improve the bioactivity of PEEK. Int J Mol Sci 15(4):5426–5445PubMedPubMedCentral

34.

Zhao Y, Wong HM, Wang W, Li P, Xu Z, Chong EYW et al (2013) Cytocompatibility, osseointegration, and bioactivity of three-dimensional porous and nanostructured network on polyetheretherketone. Biomaterials 34(37):9264–9277PubMed

35.

Khoury J, Kirkpatrick SR, Maxwell M, Cherian RE, Kirkpatrick A, Svrluga RC (2013) Neutral atom beam technique enhances bioactivity of PEEK. Nucl Instruments Methods Phys Res Sect B Beam Interact with Mater Atoms 307:630–634

36.

Kohal RJ, Wolkewitz M, Hinze M, Han J, Bächle M, Butz F (2009) Biomechanical and histological behavior of zirconia implants: an experiment in the rat. Clin Oral Implants Res 20(4):333–339PubMed

37.

Advincula MC, Rahemtulla FG, Advincula RC, Ada ET, Lemons JE, Bellis SL (2006) Osteoblast adhesion and matrix mineralization on sol–gel-derived titanium oxide. Biomaterials 27(10):2201–2212PubMed

38.

Soon G, Pingguan-Murphy B, Lai KW, Akbar SA (2016) Review of zirconia-based bioceramic: surface modification and cellular response. Ceram Int 42(11):12543–12555

39.

Zheng Y, Xiong C, Wang Z, Li X, Zhang L (2015) A combination of CO2 laser and plasma surface modification of poly (etheretherketone) to enhance osteoblast response. Appl Surf Sci 344:79–88

40.

Kiran NK, Mukunda KS, Tilak Raj TN (2011) Platelet concentrates: a promising innovation in dentistry. J Dent Sci Res 2(1):50–61

41.

Al-Maawi S, Becker K, Schwarz F, Sader R, Ghanaati S (2021) Efficacy of platelet-rich fibrin in promoting the healing of extraction sockets: a systematic review. Int J Implant Dent 7:117PubMedPubMedCentral

42.

Riveiro A, Soto R, Comesana R, Boutinguiza M d, Del Val J, Quintero F, et al. Laser surface modification of PEEK. Appl Surf Sci. 2012;258(23):9437–42.

43.

Bereznai M, Pelsöczi I, Tóth Z, Turzo K, Radnai M, Bor Z et al (2003) Surface modifications induced by ns and sub-ps excimer laser pulses on titanium implant material. Biomaterials 24(23):4197–4203PubMed

44.

Gaggl A, Schultes G, Müller WD, Kärcher H (2000) Scanning electron microscopical analysis of laser-treated titanium implant surfaces—a comparative study. Biomaterials 21(10):1067–1073PubMed

45.

Ranella A, Barberoglou M, Bakogianni S, Fotakis C, Stratakis E (2010) Tuning cell adhesion by controlling the roughness and wettability of 3D micro/nano silicon structures. Acta Biomater 6(7):2711–2720PubMed

46.

Martin A, Azhagarasan NS, Ravichandran M, Ramakrishnan H, Krishnakumar SJ, Mahadevan V (2020) Evaluation of the bioactivity of surface modified polyetheretherketone (PEEK) as an implant material: an in vitro study. Contemp Clin Dent 11(4):356PubMedPubMedCentral

47.

Guo J, Liu L, Liu H, Gan K, Liu X, Song X et al (2017) Influence of femtosecond laser on the osteogenetic efficiency of polyetheretherketone and its composite. High Perform Polym 29(9):997–1005

48.

Briski DC, Zavatsky JM, Cook BW, Ganey T (2015) Laser modified PEEK implants as an adjunct to interbody fusion: a sheep model. Glob Spine J 5(suppl):s-0035-1554347-s−0035-1554347

49.

Najeeb S, Zafar MS, Khurshid Z, Siddiqui F (2016) Applications of polyetheretherketone (PEEK) in oral implantology and prosthodontics. J Prosthodont Res 60(1):12–19PubMed

Title: Nano-topographical surface engineering for enhancing bioactivity of PEEK implants (in vitro—histomorphometric study)
Authors: Dawlat Mostafa
Youssef M. Kassem
Samia Soliman Omar
Yousreya Shalaby
Publication date: 17-10-2023
Publisher: Springer Berlin Heidelberg
Keyword: Laser
Published in: Clinical Oral Investigations / Issue 11/2023
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-023-05291-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nano-topographical surface engineering for enhancing bioactivity of PEEK implants (in vitro—histomorphometric study)

Abstract

Objectives

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2023

Discriminant validity of the current gingivitis classification in adolescents: a cohort study

Halitosis: etiology, prevention, and the role of microbiota

The relationship between Helicobacter pylori infection and recurrent aphthous stomatitis: a systematic review and meta-analysis

Impact of low-level laser therapy as an adjunct to non-surgical periodontal treatment on the levels of tissue plasminogen activator and plasminogen activator inhibitor 1 in Stage 3–4, Grade C periodontitis patients: a split-mouth, randomized control study

Evaluation of experimental resin infiltrant containing nanohydroxyapatite on color stability and microhardness in demineralized enamel

Three-dimensional evaluation of social smile asymmetry in patients with unilateral impacted maxillary canine: a 3D stereophotogrammetry study