Review on Surface Modification Strategies for Polyetheretherketone Dental Implants
Polyetheretherketone(PEEK)is a high-performance thermoplastic polymer with an elastic modulus close to that of a jawbone.PEEK has advantages such as radiolucency,chemical stability,color similarity with teeth,and low allergy rate,and has the potential to become a new type of dental implant material for patients.However,the lack of aromatic main chains,surface chemical functional groups,and charges makes PEEK hydrophobic and biologically inert,thereby limiting its clinical application.To promote the application and progress of PEEK in the field of dental implants,researchers have explored different modification methods to improve its osseointegration ability effectively.This is the first comprehensive summary and review of the mechanical,chemical,and biological performance of PEEK as a dental implant material,providing theoretical support for its development as a new implant material.It is noteworthy that its elastic modulus and density are closer to those of the mandible than those of traditional titanium alloy and zirconia implant materials.According to Wolffs law,the load is positively correlated with bone growth.Therefore,the stress distribution between PEEK and alveolar bone is more balanced,effectively avoiding bone density reduction and osteoporosis caused by long-term functional load,thus extending the clinical service life of the implants.The latest research progress in surface modification methods for enhancing PEEK osteogenic activity has been introduced.Surface modification is divided into two categories from the perspective of modification mechanisms:physical and chemical.Physical modification,including sustained-release drug delivery coatings,layer-by-layer self-assembly technology,microwave-assisted coatings,and pulsed DC magnetron sputtering,involves changing the surface morphology of a material by physical means or enhancing the osteogenic active substance on the surface of the material by physical adsorption through surface engineering technology.In contrast to physical modification,chemical modification forms a chemical bond on the surface of the material through a chemical reaction and covalently grafts the active substance to increase the binding strength of PEEK with active substances or functional groups.Current research focuses on plasma treatment,UV-induced polymerization,sulfonation,atom transfer radical polymerization,and wet chemistry.Novel and unique modification methods in this research field were selected to introduce and summarize their advantages and disadvantages.All the above modification methods have obtained good in vitro and in vivo osteogenic effects,and they have their own advantages,disadvantages,and indications.Finally,we provide a brief description of the development trends and solutions for the shortcomings of each modification method.The research trend of surface modification of PEEK is proposed and provides a reference for its future development,filling the gap in research and review related to PEEK dental implants,and providing a development direction for promoting the clinical conversion of PEEK dental implants.However,to realize the wide applications of PEEK in the field of oral implants,more in-depth research and clinical experiments are required.In addition,animal models cannot accurately simulate the complex human oral system because implants have close and inseparable interactions with the periodontal soft tissue,alveolar bone,and oral microbiota.Clinical trials applying masticatory cycle loading should be designed in the future to obtain more convincing preclinical data.Overall,PEEK surface modification is an effective means of improving its bone integration ability and has a positive expansion effect on promoting its clinical application.
polyetheretherketonesurface modificationdental implantsosseointegrationmedicinal material
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