In Vitro Effect of Modified Polyetheretherketone (PEEK) Implant Abutments on Human Gingival Epithelial Keratinocytes Migration and Proliferation

Abstract

Improving soft tissue attachment to implant abutments is a crucial factor for enduring health and maintenance of soft peri-implant tissue health. In this in vitro study we aimed to compare the biocompatibility of three different abutment surfaces: titanium, zirconia and modified polyetheretherketone (PEEK). Surface topography, roughness and wettability were investigated with scanning electron microscopy, profilometer and contact angle meter, respectively. Human gingival epithelial keratinocytes were examined for viability, morphology, proliferation and migration by using tetrazolium salt colorimetric assay, scanning electron microscopy imaging, immunofluorescence bromodeoxyuridine analysis and scratch wound healing assays. Roughness measurements revealed differences between the investigated surfaces. Keratinocytes cultured on all examined surfaces indicated adhesion and attachment by means of scanning electron microscopy imaging. Cell viability assays showed no significant differences between the groups (p > 0.05). The modified PEEK surface similarly improved surface roughness in comparison to titanium and zirconia, which resulted in greater and equivalent cell proliferation and migration. The study methodology showed here may emphasize the importance of cell interactions with different abutment materials, which in part increases the changes of implant success. PEEK, titanium and zirconia surface types used in this study showed mostly similar epithelial biological responses.

Hybrid Polyetheretherketone (PEEK)–Acrylic Resin Prostheses and the All-on-4 Concept: A Full-Arch Implant-Supported Fixed Solution with 3 Years of Follow-Up

“…In the field of dentistry, the possibility of computer-aided design/computer-aided manufacturing (CAD/CAM) together with its biocompatibility and shock absorbing features [10,16,17] has enabled the increased use of PEEK. These uses were extended to the fabrication of a considerable number of materials including healing caps, abutments, removable prostheses, crowns, fixed or partial full-arch dentures, and dental implants [10][11][12][13][14][15][18][19][20][21][22][23]. Despite the scarce in vivo publications, PEEK was demonstrated to be a valid treatment option compared to titanium in the rehabilitation of severely atrophic maxillary alveolar ridges both through patient-specific sub-periosteal implants [24] and as a customized mesh for bone augmentation [25].…”

Compromised Epithelial Cell Attachment after Polishing Titanium Surface and Its Restoration by UV Treatment

“…The results show that UV treatment is effective not only for rough surfaces but also for polished surfaces. The current results showed the enhanced expression of actin and the focal adhesion molecule vinculin, and enhanced formation of cytoplasmic processes [ 13 ]. Such enhanced early behavior is known to promote cell colonization and stimulate growth factor production, thereby promoting cell differentiation and multiple functions.…”

The Effect of Different Cleaning Protocols of Polymer-Based Prosthetic Materials on the Behavior of Human Gingival Fibroblasts

“…Average surface roughness values (Ra/Sa) in different studies range widely: PMMA 0.02–6.2 µm [ 18 , 19 , 20 , 21 , 52 ], 3D printed PMMA (SLA) 0.39–2.97 µm [ 52 , 53 ], PEEK 0.032–2.52 µm [ 15 , 18 , 19 , 20 , 24 , 52 , 54 , 55 ], and PEKK 0.24–3.11 µm [ 56 , 57 ]. In some of these studies, cleaning protocol is either not stated or not used after polishing [ 24 , 52 , 53 ]. Most commonly, an ultrasonic bath filled either with water or alcohol (e.g., 70% ethanol or isopropanol) with consecutive water washing was used from 3 up to 20 min [ 15 , 18 , 20 , 21 , 54 , 55 , 57 ].…”

“…Concerns of lower biocompatibility of PMMA (polymethylmethacrylate) materials were raised in the literature (e.g., cytotoxicity of PMMA monomers, higher surface bacterial contamination compared to other materials); however, they are widely used for fabrication of provisional restorations [ 18 , 19 , 20 , 21 , 22 ]. PEEK (polyetheretherketone) materials have gained more attention in recent years as an alternative to titanium and ceramics [ 15 , 18 , 19 , 23 , 24 ]. Scientific evidence shows that PEEK and its modifications are favorable for fibroblast and epithelial cell response and might provide less biofilm formation [ 15 , 18 , 24 ].…”

“…PEEK (polyetheretherketone) materials have gained more attention in recent years as an alternative to titanium and ceramics [ 15 , 18 , 19 , 23 , 24 ]. Scientific evidence shows that PEEK and its modifications are favorable for fibroblast and epithelial cell response and might provide less biofilm formation [ 15 , 18 , 24 ]. On the other hand, studies regarding 3D printed materials and novel polymers (e.g., PEKK—polyetherketoneketone) remain limited.…”