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2023
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Title: Biomaterials and clinical application of dental implants in relation to bone density – A narrative review |
Type: Dental/review | To assess how implant materials, designs, and surgical techniques impact bone density, focusing on titanium, zirconia, and PEEK implants, and to determine the optimal choices for varying bone densities | Analysis of literature on the biomechanical and biological effects of dental implant materials and designs on bone density |
| Titanium is preferred for its reliability, though it presents visibility issues in thin gums and allergy concerns |
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Author: Khaohoen et al.
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| Zirconia is chosen for aesthetics and metal sensitivity but may fracture more easily |
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Keywords: biomaterial, bone density, dental implants, … |
| PEEK is promising for its bone-like properties, yet requires further research |
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Reference: [21] |
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| Implant geometry is critical, especially in low-density bone, to enhance stability |
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2023
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Title: Evaluation of stresses on mandible bone and prosthetic parts in fixed prosthesis by utilizing CFR-PEEK, PEKK, and PEEK frameworks |
Type: Dental/FEA | The article aims to assess the impact of using polymeric frameworks instead of titanium on stress distribution within the components of fixed prostheses and surrounding bone tissue, considering the influence of spongy bone density on the success of fixed prosthesis in edentulous patients | A FEA assessed stress distribution in an edentulous mandible with fixed prostheses using polymeric materials (CFR-PEEK 60%, CFR-PEEK 30%, PEKK, PEEK) vs titanium, simulating unilateral and bilateral 300 N forces on prostheses in spongy bones of varying densities (normal, low, high) |
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CFR-PEEK 60%
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CFR-PEEK 30%
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PEKK
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PEEK
| The study showed that the PEEK framework minimized stress on bone tissues and increased mucosa stress, thus reducing bone resorption risk |
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Author: Shash et al.
| Frameworks tested (CFR-PEEK 60%, CFR-PEEK 30%, PEKK, PEEK) worked well in normal and high spongy bone densities |
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Reference: [22] |
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2023
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Title: Evaluation of stress and strain on mandible caused by changing the bar material in hybrid prosthesis utilizing “All-on-Four” technique |
Type: Dental/FEA | The research aimed to explore the viability of using ceramics, polymers, and composites as alternative materials for the bar component in hybrid prostheses, traditionally made of titanium or gold, to address full edentulism and restore the mastication mechanism | A 3D mandible model with a hybrid prosthesis was analyzed using various bar materials. The study measured von Mises stress on the prosthesis and mandible, including maximum and minimum principal stresses and strains on the bone. The simulation tested unilateral and bilateral forces to evaluate their impact on cortical and cancellous bones and mucosa stress |
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Porcelain
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Zirconia
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Alumina
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ZTA
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ATZ
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PEKK
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PEEK
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CFR-PEEK
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GFR-PEEK
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FRR
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HA-PEEK
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BIOHPP
| A PEEK bar reduced von Mises stresses on cortical and cancellous bones significantly under unilateral and bilateral forces, while slightly increasing mucosa stress, remaining below pain thresholds. Despite these variations, all materials, including ceramics, polymers, and composites, kept bone stresses within safe limits, suggesting they are viable alternatives to titanium for hybrid prosthesis bars |
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Author: Shash et al.
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Reference: [23] |
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2022
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Title: Properties of polyetheretherketone (PEEK) implant abutments: A systematic review |
Type: Dental/review | To know the mechanical and functional properties of PEEK abutment and to find out if it is a potential substitute for titanium abutments | The search focused on studies from 2018 to 2020 in English, documented in PROSPERO with ID 274834. Data extraction and quality evaluation adhered to revised CONSORT standards |
| The existing data indicate that PEEK implant abutments lack the necessary biomechanical properties to serve as a permanent replacement for titanium abutments. Nonetheless, they are regarded as a suitable temporary option, particularly if placed in the anterior region |
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Author: Ghazal-Maghras et al.
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Keywords: Abutment, polyetheretherketone, titanium, dynamic fatigue, … |
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Reference: [24] |
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2022
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Title: Influence of different combinations of CAD-CAM crown and customized abutment materials on the force absorption capacity in implant supported restorations – In vitro study |
Type: Dental/experimental study | To assess the capability of implant-supported restorations to absorb force, employing various CAD-CAM materials in the creation of crowns and customized abutments | Utilized 12 3D finite element models, 6 implant designs, applied axial loads, and analyzed displacements, stress, and strain in bone tissue |
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Titanium (Ti) alloy
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PEEK
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Ti-PEEK composite
| Force curve progression varied by material. Zirconia abutments had highest slopes in ZZ, then EZ, VZ, PZ. PEEK abutments showed least slopes in ZP, EP. PEEK abutments increased slope loss in Zirconia, e.max crowns but not in PEEK, Vita Enamic crowns |
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Author: Taha et al.
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Keywords: customized abutments, force, force absorption, implant prosthetics, … |
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R
eference: [25] |
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2022
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Title:
In vitro assessment of PEEK and titanium implant abutments: Screw loosening and microleakage evaluations under dynamic mechanical testing |
Type: Dental/experimental study | This in vitro study aimed to evaluate the mechanical and functional properties of PEEK implant abutments as an aesthetic, non-metallic alternative to traditional titanium abutments, which have aesthetic limitations and are more challenging to customize in clinical settings | In this study, 24 PEEK and 24 titanium grade 5 implant abutments fixed to MIS Implants type M4 were tested for screw loosening and microleakage in a 2% methylene blue solution, under static and dynamic conditions following ISO 14801:2016 standards. Observations at 8× magnification and statistical analysis (2-factor ANOVA, chi-square) compared the PEEK and titanium groups |
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PEEK for manufacturing half of the implant abutments.
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Titanium grade 5 for the other half of the implant abutments.
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MIS Implants type M4 (3.75 × 16 mm)
| The study showed that titanium implant abutments performed better mechanically than PEEK abutments, with titanium experiencing around 10% torque loss compared to PEEK’s, which is up to 50%. Additionally, 91.6% of titanium abutments had no microleakage, whereas all PEEK abutments did under dynamic loading |
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Author: Ortega-Martínez et al.
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Reference: [26] |
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2022
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Title: Biomaterials and clinical applications of customized healing abutment – A narrative review |
Type: Dental/review | The article aims to assess materials for customized healing abutments used in implant surgery to enhance tissue appearance and reduce treatment and prosthesis fabrication time | A literature review was conducted, searching English-language articles on customized healing abutments in Google Scholar, PubMed/MEDLINE, ScienceDirect, and Scopus databases up to August 2022 |
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PEEK
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PMMA
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Zirconia
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Resin composite
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Titanium
| All materials—PEEK, PMMA, zirconia, resin composite, and titanium—showed promising results for customized healing abutments. However, more research is needed to compare their effects on peri-implant tissues conclusively |
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Author: Chokaree et al.
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Keywords: PEEK, PMMA, customized healing abutment, … |
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Reference: [27] |
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2022
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Title: PEEK biomaterial in long-term provisional implant restorations: A review |
Type: Dental/review | The review article examines PEEK as a material for long-term provisional implant restorations in dental implantology, highlighting its growing use in various dental procedures | A comprehensive search across Google Scholar, ScienceDirect, PubMed/MEDLINE, and Scopus identified English-language articles on PEEK as a biomaterial for long-term provisional implant restorations, selecting relevant ones for literature review |
| PEEK, especially when enhanced with 30–50% carbon fibers, is recognized for its broad applicability in implant dentistry, including dental implants, temporary abutments, and various prostheses, indicating its promise for both temporary and long-term provisional restorations. This suggests potential for wider clinical use |
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Author: Suphangul et al.
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Keywords: PEEK, carbon fiber, implant abutment, … |
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Reference: [28] |
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2021
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Title: Stress distribution around different abutments on titanium and CFR-PEEK implant with different prosthetic crowns under parafunctional loading: A 3D FEA study |
Type: Dental/FEA | Clinical studies linked implant failure to bruxism, while 3D FEA evaluated stress distribution in straight and angled abutments with titanium and CFR-PEEK implants and two crown types under parafunctional loading | Twelve 3D bone block models of the maxillary right premolar with osseointegrated implants were divided into CFR-PEEK and titanium groups, each featuring three abutment angles and two crown types. Stresses from 1,000 N vertical and 500 N oblique loads were analyzed using ANSYS software |
| Both CFR-PEEK and titanium implants yielded similar bone stress under vertical and oblique loads, with straight abutments outperforming angled ones, and PEEK crowns inducing less stress than (PFM) |
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Author: Mourya et al.
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Reference: [29] |
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2021
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Title: Biomechanical performance of Ti-PEEK dental implants in bone: An in-silico analysis |
Type: Dental/experimental study and FEA | To compare Ti-PEEK composite dental implants with conventional titanium implants, assessing host bone behavior, especially under conditions of marginal bone loss | Utilized 12 3D FEMs, six implant designs, applied axial loads, and analyzed displacements, stress, and strain in bone tissue |
| Ti-PEEK implants outperformed conventional dense titanium implants (Implant A) in non-bone loss conditions. However, in bone loss scenarios, both Implant A (made entirely of dense titanium) and Implant E (designed with titanium in the upper half and PEEK in the lower half) showed equal effectiveness |
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Author: Ouldyerou et al.
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Keywords: Bone, Composite, Implant, Mechanostat, Ti-PEEK |
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Reference: [30] |
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2020
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Title: Comparative evaluation of the wear resistance of two different implant abutment materials after cyclic loading |
Type: Dental/experimental study | The paper aims to compare the wear resistance of titanium and PEEK abutment materials when paired with titanium implants after cyclic loading, assessing significant differences in wear resistance under repeated mechanical stress | The study involved 20 titanium implants in resin blocks, divided into groups with titanium and PEEK abutments, each undergoing 550,000 cycles of cyclic loading. Surface roughness was measured by profilometry, abutment surfaces imaged by SEM, and elemental analysis conducted using EDS, to evaluate changes at the implant-abutment interface before and after loading |
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Titanium (Ti): Group I
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PEEK: Group II
| The study compared wear resistance of titanium and PEEK abutment materials connected to titanium implants after cyclic loading, finding no significant difference in wear patterns or surface roughness changes between the two, as confirmed by SEM and EDS analyses. Both materials are comparably effective for dental implant abutments, with PEEK offering an aesthetic alternative |
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Author: Ragupathi et al.
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Keywords: Abutment, Polyether ether Ketone, implant-abutment interface, … |
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Reference: [31] |
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2019
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Title: Effect of different biocompatible implant materials on the mechanical stability of dental implants under excessive oblique load |
Type: Dental/FEA | The study evaluates the impact of replacing traditional titanium with carbon reinforced polyether ether ketone (CRF-PEEK) composites on stress distribution in peri-implant bone under excessive oblique loading, examining if CRF-PEEK’s bone-like mechanical properties can enhance stress distribution and decrease implant failure risks | The methodology includes constructing 3D models of a dental implant in the first mandibular molar from CT scans and creating five models using titanium, CRF-PEEK, and lithium disilicate. It employs 3D FEA to assess stress distribution at the implant-bone interface under excessive oblique loads and examines physical interactions, including friction effects between contacting surfaces |
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Titanium (Ti)
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CRF-PEEK
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Lithium disilicate
| The study compared wear resistance between titanium and PEEK abutment materials connected to titanium implants post-cyclic loading, revealing only slight and statistically insignificant differences in surface roughness and wear patterns as confirmed by SEM and EDS analyses. Both materials proved comparably effective for dental implant abutments, with PEEK also offering aesthetic benefits |
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Author: Bataineh et al.
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Keywords: CFR-PEEK, biocompatible, biomaterials, deformation, dental implant, … |
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Reference: [32] |
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2018
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Title: 3D FEA study on implant threading role on selection of implant and crown materials |
Type: Dental/FEA | Examination of the impact of thread design in dental implants and the choice of material on mandibular bone response, considering two distinct crown materials: Translucent zirconia and PFM | Two single-piece dental implant designs with a proxy crown were modeled on simplified bone structures in FEA. CAD/CAM software crafted the components, which were assembled and analyzed in ANSYS, applying 100 N compressive and 50 N oblique loads |
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Reinforced PEKK
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PEEK
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Titanium
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Zirconia
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PFM
| In 24 cases, micro-threading slashed the dental implant’s peak Von Mises stress by 50–70% compared to conventional threading. A 50 N oblique force generated 4–5 times the stress on the implant as a 100 N vertical load. Crown material swaps had minimal impact on cortical bone stress, while titanium implants cut stress by 50–100% vs reinforced PEKK or PEEK |
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Author: Wazeh et al.
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Keywords: Dental implant, FEA, PEEK, PEKK, Titanium |
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Reference: [33] |
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2018
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Title: Computational modelling; damage mechanics; laminated orthopaedic devices; mechanical testing; medical grade carbon fiber reinforced PEEK |
Type: Dental/FEA | The study focuses on the mechanical behavior and failure mechanisms of PEEK-OPTIMA™ Ultra-Reinforced, a unidirectional CFR-PEEK, to develop laminated orthopedic devices and predictive computational models | A series of multi-axial experimental tests were conducted, including tension, compression, in-plane shear, and fracture toughness tests, along with the development of a computational failure model that incorporates observed damage mechanisms | PEEK-OPTIMA™ Ultra-Reinforced laminates | The study identifies three key damage mechanisms: inter-laminar delamination, intra-laminar cracking, and anisotropic plasticity. The computational model effectively predicts these complex failure mechanisms, supporting the design of safe, fiber-reinforced laminated orthopaedic devices |
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Author: Gallagher et al.
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Keywords: computational modelling, damage mechanics, … |
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Reference: [34] |
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2018
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Title: Effect of different restorative crown and customized abutment materials on stress distribution in single implants and peripheral bone: A three-dimensional FEA study |
Type: Dental/FEA | To evaluate the stress distribution effects of resin-matrix ceramic and PEEK customized abutments on dental implants and adjacent bone using FEA | The study used 3D modeling with STL data to create implant systems and abutments, and developed six models combining different restoration materials (TZI, IPS, VTE) and abutments (PEEK, zirconia). These models were subjected to vertical (200 N) and oblique (100 N) loads, analyzing stress distribution via von Mises and principal stress methods |
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Bone-level implant system
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Titanium base abutment
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Translucent zirconia (TZI) for restoration
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Lithium disilicate glass ceramic (IPS) for restoration
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Polymer-infiltrated hybrid ceramic (VTE) for restoration
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PEEK for customized abutments
| Oblique loading induced elevated stress in implants, crowns, and cortical bone, with VTE crowns showing lower stress. Zirconia abutments faced greater stress than PEEK ones. Stress patterns in implants and surrounding bone remained consistent across all models |
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Author: Kaleli et al.
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Reference: [35] |
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2016
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Title: Comparison between PEEK and Ti6Al4V concerning micro-scale abrasion wear on dental applications |
Type: Dental/experimental study | The study compared the abrasive wear resistance of PEEK and titanium alloy (Ti6Al4V) under simulated three-body abrasion conditions to mimic wear from food and toothpaste during mastication and tooth brushing | The study conducted micro-scale abrasion tests on PEEK and Ti6Al4V cylinders, using varied loads and hydrated silica suspensions, measuring wear volumes and analyzing wear scars with SEM to determine wear mechanisms |
| The study revealed that under three-body abrasion tests with hydrated silica suspensions, PEEK showed higher volume loss and lower wear resistance than Ti6Al4V, which consistently outperformed PEEK across different abrasive contents and loads |
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Author: Sampaio et al.
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Keywords: Bio-tribology, micro-scale abrasion, PEEK, Ti6Al4V, wear |
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Reference: [36] |
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2016
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Title: Effects of PEEK veneer thickness on the reciprocating friction and wear behavior of PEEK/Ti6Al4V structures in artificial saliva |
Type: Dental/FEA | The study examines how varying thicknesses of PEEK veneers impact friction, wear rate, and contact stress on Ti6Al4V substrates, crucial for the durability and effectiveness of biomedical materials in oral applications | PEEK veneers from 0.1 to 2 mm thick were synthesized on Ti6Al4V substrates, tested for friction and wear against alumina in artificial saliva at 37°C, and analyzed via simulations to study the effect of thickness on contact stress |
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PEEK
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Ti6Al4V alloy
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Alumina (Al2O3)
| Thinner PEEK veneers show higher coefficients of friction and wear rates due to increased contact stress, underscoring the importance of considering veneer thickness in designing biomedical devices, particularly for oral applications requiring optimal friction and wear resistance for long-term success |
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Author: Sampaio et al.
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Keywords: Biotribology, Ti6Al4V, PEEK, sliding wear, thickness, FEM model |
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Reference: [37] |
| 2016 |
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Title: Pressure behavior of different PEEK materials for dental implants |
Type: Dental/experimental study | Evaluate the mechanical properties of different PEEK composites under static pressure | Nine PEEK composites (11 applications biomedical, 2 applications industrial) tested under static pressure |
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VESTAKEEP® M4 R
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PEEK-OPTIMA® LT1
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PEEK-CLASSIX® BICI
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Mechanical properties: Elastic modulus, yield limit, resistance to compression |
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Author: Schwitalla et al.
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Reference: [38] |
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2015
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Title: FEA of the biomechanical effects of PEEK dental implants on the peri-implant bone |
Type: Dental/FEA | Show the biomechanical behavior differences of three implants (two PEEK vs one titanium) |
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Mechanical properties: Modulus of elasticity, coefficient of Poisson |
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Author: Schwitalla et al.
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Stresses at the bone/implant: Ultimate tensile stress, von Mises, deformation and pressure on the peri-implant bone |
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Reference: [39] |
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2015
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Title: Flexural behavior of PEEK materials for dental application | Type: Dental/experimental study | Evaluate the mechanical properties of different PEEK composites by the three-point bending test |
In vitro
study: 150 specimens in the form of a bar made from 11 PEEK composites (9 applications biomedical, 2 applications industrial) tested by three-point bending test |
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VESTAKEEP® M4 R
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PEEK-OPTIMA® LT1
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PEEK-CLASSIX®
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VESTAKEEP®
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…
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Mechanical properties: Bending modulus, resistance to flexion |
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Author: Schwitalla et al.
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Reference: [40] |
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2015
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Title: Applications of PEEK in oral implantology and prosthodontics |
Type: Dental/review | Synthesize the results of research conducted on PEEK in dental applications and provide perspectives on the use of PEEK and its potential clinical applications | Electronic research of English publications over the last 15 years on PubMed using a combination of keywords “polyetheretherketone” and “dental” and “dentistry” |
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Unmodified PEEK
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CFR-PEEK
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Modified PEEK:
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Mechanical properties: Elastic modulus, resistance to traction |
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Author: Najeeb et al.
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Reference: [41] |
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2012
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Title: Stress shielding and fatigue limits of poly-ether-ether-ketone dental implants |
Type: Dental/experimental study | To evaluate fatigue limits of PEEK and its effects on stress shielding in comparison to traditional titanium dental implants | The study used compressive loading tests on GFR-PEEK, CFR-PEEK, and titanium rods, with GFR-PEEK tested as per ISO 14801. FEA involved 3D models of dental implants and bone. PEEK layer coating was applied to implants for further testing and analysis |
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PEEK
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GFR-PEEK
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CFR-PEEK
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Titanium rods
| GFR-PEEK’s fatigue limit reached 310 N, exceeding static strength. PEEK implants displayed elevated SED near bone. Both GFR and CFR-PEEK implants are suitable for anterior tooth replacement, potentially reducing stress shielding |
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Author: Lee et al.
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Reference: [42] |
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2010
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Title: A “metal free” material in implantology: the Biopik® |
Type: Dental/Review | Presentation of the mechanical and biological properties of “Biopik®“ with a view of its application in implantology | Presentation of Biopik® | Biopik®: Tricalcium phosphate (TCP) 10% + titanium oxide (TiO2) 10% + PEEK matrix |
Mechanical properties: Young’s modulus |
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Author: Cougoulic et al.
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In vitro
study of the interface human osteogenic cells/material |
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Reference: [43] |
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In vivo
study, animal experimentation on osseointegration at 4 weeks |
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2010
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Title: Evaluation of the stress distribution in CFR-PEEK dental implants by the three-dimensional FEM |
Type: Dental/FEA | The stress dispersion around peri-implant bone was evaluated using FEM across four configurations: titanium abutment on titanium implant, CFR-PEEK abutment on titanium implant, titanium abutment on CFR-PEEK implant, and CFR-PEEK abutment on CFR-PEEK implant | Cone beam computed tomography was used to create 3D jaw models analyzed via Ansys software for FEM simulations, assessing stress distribution on various abutment-implant configurations in cortical and medullar bone, employing nonlinear simulations with rigid supports to evaluate mechanical response under varied loads |
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Titanium
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CFR-PEEK
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Cortical and medullar bone tissues
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Feldspathic porcelain for the crown structure
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Chrome-cobalt structure within the crown
| The titanium implant distributes the stresses in a more homogenous manner in relation to the CFR-PEEK implant due to the smaller deformation of this material. The CFR-PEEK implant did not present any advantages in relation to the titanium implant regarding stress distribution to the peri-implant bone |
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Author: Sarot et al.
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Reference: [44] |
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2006
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Title: The long-term mechanical integrity of non-reinforced PEEK-OPTIMA polymer for demanding spinal applications: Experimental and finite-element analysis |
Type: Dntal/experimental study and FEA | Compare the biomechanical performances of PEEK and titanium under constraints and analyze their diffusions |
In vitro
study: creep and quasi-static compression tests at one and three times in dry conditions and in saline solution (NaCl) at 37°C on cylindrical specimens of PEEK and titanium |
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Mechanical properties: Modulus of elasticity, creep |
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Author: Ferguson et al.
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Stresses at the bone/implant interface: Analysis of the stress distribution after compression, bending, lateral bending, and axial rotation constraints |
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Keywords: PEEK, material properties, creep, cages, fusion |
Finite element study: 3D modeling of vertebrae and simulation of intervertebral cage implant placement based on PEEK and titanium to compare stress diffusion under different constraints |
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Reference: [45] |
![Occlusal view of implants with PEEK abutments (a) following installation and (b) at 3 months. And, occlusal view of implants with titanium abutments (c) following installation and (d) at 3 months [79].](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6938634ba2cfbc128b1cfef9/j_rams-2024-0031_fig_004.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=ASIA6AP2G7AKC3522UWU%2F20251212%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251212T092636Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjEDkaDGV1LWNlbnRyYWwtMSJHMEUCIQC%2BQfKW5N5JBG%2FGTUK1Ddg%2BFHMy7CCph8HJvJRHrnwxLQIgOanKEyn9%2Bo1M2Ux%2FTqFXNo9GIguZfSvTxkZ4ODONHxwqvQUIAhACGgw5NjMxMzQyODk5NDAiDNmcz7mmWd%2ByHyWFXSqaBca2WeDmL0ylQGyAwWbHkxwYhnn9qCr3dXNfeV1UIGFwVVXFTW9J0x8l%2FobHjabimJrNoiuSio73%2BzbZwW7rlyRJpDeiY62uzWn7Tmm2A%2FAy2ChDr%2F%2B0u3rkWr3S9CD2%2Fh0cVlBCMPZCpxTK%2BJbHZoB%2F6TREBwts2XG%2BYOs7rW4fuPBfTFW22LKpXf1SxdA2BCkpcI4mat9907otV0ZLop9qCyCiF%2Belg7JccCC4fiHUITG9%2B4EXhCxvU9qYIDmgXFJaGkjfuwLJSxOPZ72u8vIXlpigJlR%2BDsPEy7VaJc3hoLumUK0wfKkKK9GSrx4tjtDEEa3m%2B2rgq9CISYMqLl2JR9DhBdoXf%2Fw%2F88rw%2FkFmW0ZDaff8WZpKafbCny5KHm4VD8uQvc6GMxULMI319N33AtRNeHv68PkBHXtiaCr9CHT30Pu4TL%2BYuEF%2BJHiBUQm3dSXnZ0MUoBA6F3fMcpeYUjXIuObf%2B2FKiY4rdKxDA%2BQ%2BpL6P2vgyhH7Pfmjn7S1H0yO%2B8bHWSHXSObzpezY1aPFowyWgn9QKjiYKfqZvCltLTUko1QQCj2zsNwVJnyL3RCME0E906K5n4fTgMz0hXegLW69MrNNg0dn4jPNN8cL5mS0D9Ge0qw4rVmZxgDRxWeRr0lzCUC3QXGN3rFchBIKCcUAL7P7UEGam5E2xOvgrDRJChfS6EODwMtnGY06xvELPC0KqQSZnXbpkMIKt1JIv1U5do%2BYE0uqEtU2Y%2Fgifb2a7MmdHpD%2BOZt4t8%2FjtryZCOXrayOsc7KoeBucESjdSsIWpBbOuSFJyIII4ck9TM2jnxmdjYlNtxWBOlLmmDka4y0stOlQz192O3eaipUWYvBLMtZnOnfMEF741RWEGFOQ2b0TwqDCer%2B%2FJBjqxAW4NnZodJUXY96PxpqFzqL6n1pL8JT2lQ4LVr8c4pftcXMAU7ouVfyQPSgVc2lwaSxkXUBj21zT50VxNK4fHtlyFFz4Lz3DTQCYNH%2BCq3PGxqXLTIN170tnl0CApuctAJHBWAwXJya3ZyxeI170LibMcV5TVp4DEYWKlKW7Ltn0zkR3ZFEL58x4ngXcc0qizg9%2FuxM3%2F1uhkmatbLC2l3IA6Io3jpmtXzXmvB%2FDe4Ls77w%3D%3D&X-Amz-Signature=003c39e75e13a9561388303b20df2da37273566fe108c0afed7ecaa5d3108b47&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
![PEEK resin-bonded fixed dental prosthesis: (a) occlusal view and (b) after fixing the teeth [94].](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6938634ba2cfbc128b1cfef9/j_rams-2024-0031_fig_006.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=ASIA6AP2G7AKC3522UWU%2F20251212%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251212T092636Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjEDkaDGV1LWNlbnRyYWwtMSJHMEUCIQC%2BQfKW5N5JBG%2FGTUK1Ddg%2BFHMy7CCph8HJvJRHrnwxLQIgOanKEyn9%2Bo1M2Ux%2FTqFXNo9GIguZfSvTxkZ4ODONHxwqvQUIAhACGgw5NjMxMzQyODk5NDAiDNmcz7mmWd%2ByHyWFXSqaBca2WeDmL0ylQGyAwWbHkxwYhnn9qCr3dXNfeV1UIGFwVVXFTW9J0x8l%2FobHjabimJrNoiuSio73%2BzbZwW7rlyRJpDeiY62uzWn7Tmm2A%2FAy2ChDr%2F%2B0u3rkWr3S9CD2%2Fh0cVlBCMPZCpxTK%2BJbHZoB%2F6TREBwts2XG%2BYOs7rW4fuPBfTFW22LKpXf1SxdA2BCkpcI4mat9907otV0ZLop9qCyCiF%2Belg7JccCC4fiHUITG9%2B4EXhCxvU9qYIDmgXFJaGkjfuwLJSxOPZ72u8vIXlpigJlR%2BDsPEy7VaJc3hoLumUK0wfKkKK9GSrx4tjtDEEa3m%2B2rgq9CISYMqLl2JR9DhBdoXf%2Fw%2F88rw%2FkFmW0ZDaff8WZpKafbCny5KHm4VD8uQvc6GMxULMI319N33AtRNeHv68PkBHXtiaCr9CHT30Pu4TL%2BYuEF%2BJHiBUQm3dSXnZ0MUoBA6F3fMcpeYUjXIuObf%2B2FKiY4rdKxDA%2BQ%2BpL6P2vgyhH7Pfmjn7S1H0yO%2B8bHWSHXSObzpezY1aPFowyWgn9QKjiYKfqZvCltLTUko1QQCj2zsNwVJnyL3RCME0E906K5n4fTgMz0hXegLW69MrNNg0dn4jPNN8cL5mS0D9Ge0qw4rVmZxgDRxWeRr0lzCUC3QXGN3rFchBIKCcUAL7P7UEGam5E2xOvgrDRJChfS6EODwMtnGY06xvELPC0KqQSZnXbpkMIKt1JIv1U5do%2BYE0uqEtU2Y%2Fgifb2a7MmdHpD%2BOZt4t8%2FjtryZCOXrayOsc7KoeBucESjdSsIWpBbOuSFJyIII4ck9TM2jnxmdjYlNtxWBOlLmmDka4y0stOlQz192O3eaipUWYvBLMtZnOnfMEF741RWEGFOQ2b0TwqDCer%2B%2FJBjqxAW4NnZodJUXY96PxpqFzqL6n1pL8JT2lQ4LVr8c4pftcXMAU7ouVfyQPSgVc2lwaSxkXUBj21zT50VxNK4fHtlyFFz4Lz3DTQCYNH%2BCq3PGxqXLTIN170tnl0CApuctAJHBWAwXJya3ZyxeI170LibMcV5TVp4DEYWKlKW7Ltn0zkR3ZFEL58x4ngXcc0qizg9%2FuxM3%2F1uhkmatbLC2l3IA6Io3jpmtXzXmvB%2FDe4Ls77w%3D%3D&X-Amz-Signature=15dd404a6cd829c3b80a72bc522a23ca275cd00878f88cc55ec62f781eed9c56&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
![PEEK abutment made by BioHPP [99].](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6938634ba2cfbc128b1cfef9/j_rams-2024-0031_fig_007.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=ASIA6AP2G7AKC3522UWU%2F20251212%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251212T092636Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjEDkaDGV1LWNlbnRyYWwtMSJHMEUCIQC%2BQfKW5N5JBG%2FGTUK1Ddg%2BFHMy7CCph8HJvJRHrnwxLQIgOanKEyn9%2Bo1M2Ux%2FTqFXNo9GIguZfSvTxkZ4ODONHxwqvQUIAhACGgw5NjMxMzQyODk5NDAiDNmcz7mmWd%2ByHyWFXSqaBca2WeDmL0ylQGyAwWbHkxwYhnn9qCr3dXNfeV1UIGFwVVXFTW9J0x8l%2FobHjabimJrNoiuSio73%2BzbZwW7rlyRJpDeiY62uzWn7Tmm2A%2FAy2ChDr%2F%2B0u3rkWr3S9CD2%2Fh0cVlBCMPZCpxTK%2BJbHZoB%2F6TREBwts2XG%2BYOs7rW4fuPBfTFW22LKpXf1SxdA2BCkpcI4mat9907otV0ZLop9qCyCiF%2Belg7JccCC4fiHUITG9%2B4EXhCxvU9qYIDmgXFJaGkjfuwLJSxOPZ72u8vIXlpigJlR%2BDsPEy7VaJc3hoLumUK0wfKkKK9GSrx4tjtDEEa3m%2B2rgq9CISYMqLl2JR9DhBdoXf%2Fw%2F88rw%2FkFmW0ZDaff8WZpKafbCny5KHm4VD8uQvc6GMxULMI319N33AtRNeHv68PkBHXtiaCr9CHT30Pu4TL%2BYuEF%2BJHiBUQm3dSXnZ0MUoBA6F3fMcpeYUjXIuObf%2B2FKiY4rdKxDA%2BQ%2BpL6P2vgyhH7Pfmjn7S1H0yO%2B8bHWSHXSObzpezY1aPFowyWgn9QKjiYKfqZvCltLTUko1QQCj2zsNwVJnyL3RCME0E906K5n4fTgMz0hXegLW69MrNNg0dn4jPNN8cL5mS0D9Ge0qw4rVmZxgDRxWeRr0lzCUC3QXGN3rFchBIKCcUAL7P7UEGam5E2xOvgrDRJChfS6EODwMtnGY06xvELPC0KqQSZnXbpkMIKt1JIv1U5do%2BYE0uqEtU2Y%2Fgifb2a7MmdHpD%2BOZt4t8%2FjtryZCOXrayOsc7KoeBucESjdSsIWpBbOuSFJyIII4ck9TM2jnxmdjYlNtxWBOlLmmDka4y0stOlQz192O3eaipUWYvBLMtZnOnfMEF741RWEGFOQ2b0TwqDCer%2B%2FJBjqxAW4NnZodJUXY96PxpqFzqL6n1pL8JT2lQ4LVr8c4pftcXMAU7ouVfyQPSgVc2lwaSxkXUBj21zT50VxNK4fHtlyFFz4Lz3DTQCYNH%2BCq3PGxqXLTIN170tnl0CApuctAJHBWAwXJya3ZyxeI170LibMcV5TVp4DEYWKlKW7Ltn0zkR3ZFEL58x4ngXcc0qizg9%2FuxM3%2F1uhkmatbLC2l3IA6Io3jpmtXzXmvB%2FDe4Ls77w%3D%3D&X-Amz-Signature=4336f373effbf36ecb45b23461766edea7babdc7d1610eea64576f65981b33e3&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
![The distribution of von Mises stresses (MPa) on the mucosa, cortical and spongy bones, under unilateral force, using Ti and PEEK [27].](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6938634ba2cfbc128b1cfef9/j_rams-2024-0031_fig_009.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=ASIA6AP2G7AKC3522UWU%2F20251212%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251212T092636Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjEDkaDGV1LWNlbnRyYWwtMSJHMEUCIQC%2BQfKW5N5JBG%2FGTUK1Ddg%2BFHMy7CCph8HJvJRHrnwxLQIgOanKEyn9%2Bo1M2Ux%2FTqFXNo9GIguZfSvTxkZ4ODONHxwqvQUIAhACGgw5NjMxMzQyODk5NDAiDNmcz7mmWd%2ByHyWFXSqaBca2WeDmL0ylQGyAwWbHkxwYhnn9qCr3dXNfeV1UIGFwVVXFTW9J0x8l%2FobHjabimJrNoiuSio73%2BzbZwW7rlyRJpDeiY62uzWn7Tmm2A%2FAy2ChDr%2F%2B0u3rkWr3S9CD2%2Fh0cVlBCMPZCpxTK%2BJbHZoB%2F6TREBwts2XG%2BYOs7rW4fuPBfTFW22LKpXf1SxdA2BCkpcI4mat9907otV0ZLop9qCyCiF%2Belg7JccCC4fiHUITG9%2B4EXhCxvU9qYIDmgXFJaGkjfuwLJSxOPZ72u8vIXlpigJlR%2BDsPEy7VaJc3hoLumUK0wfKkKK9GSrx4tjtDEEa3m%2B2rgq9CISYMqLl2JR9DhBdoXf%2Fw%2F88rw%2FkFmW0ZDaff8WZpKafbCny5KHm4VD8uQvc6GMxULMI319N33AtRNeHv68PkBHXtiaCr9CHT30Pu4TL%2BYuEF%2BJHiBUQm3dSXnZ0MUoBA6F3fMcpeYUjXIuObf%2B2FKiY4rdKxDA%2BQ%2BpL6P2vgyhH7Pfmjn7S1H0yO%2B8bHWSHXSObzpezY1aPFowyWgn9QKjiYKfqZvCltLTUko1QQCj2zsNwVJnyL3RCME0E906K5n4fTgMz0hXegLW69MrNNg0dn4jPNN8cL5mS0D9Ge0qw4rVmZxgDRxWeRr0lzCUC3QXGN3rFchBIKCcUAL7P7UEGam5E2xOvgrDRJChfS6EODwMtnGY06xvELPC0KqQSZnXbpkMIKt1JIv1U5do%2BYE0uqEtU2Y%2Fgifb2a7MmdHpD%2BOZt4t8%2FjtryZCOXrayOsc7KoeBucESjdSsIWpBbOuSFJyIII4ck9TM2jnxmdjYlNtxWBOlLmmDka4y0stOlQz192O3eaipUWYvBLMtZnOnfMEF741RWEGFOQ2b0TwqDCer%2B%2FJBjqxAW4NnZodJUXY96PxpqFzqL6n1pL8JT2lQ4LVr8c4pftcXMAU7ouVfyQPSgVc2lwaSxkXUBj21zT50VxNK4fHtlyFFz4Lz3DTQCYNH%2BCq3PGxqXLTIN170tnl0CApuctAJHBWAwXJya3ZyxeI170LibMcV5TVp4DEYWKlKW7Ltn0zkR3ZFEL58x4ngXcc0qizg9%2FuxM3%2F1uhkmatbLC2l3IA6Io3jpmtXzXmvB%2FDe4Ls77w%3D%3D&X-Amz-Signature=4276f5ea192903e2b6c9cc99d39cdb0add2ac99ed9f83c00f2e03e5803ee01c4&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
![Stress in: (a) CFR-PEEK 15° abutment under vertical loading with PFM crown, (b) CFR-PEEK straight abutment under oblique loading with (PFM) crown, (c) titanium straight abutment under vertical loading with (PFM) crown, and (d) titanium straight abutment under oblique loading with (PFM) crown [29].](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6938634ba2cfbc128b1cfef9/j_rams-2024-0031_fig_010.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=ASIA6AP2G7AKC3522UWU%2F20251212%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251212T092636Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjEDkaDGV1LWNlbnRyYWwtMSJHMEUCIQC%2BQfKW5N5JBG%2FGTUK1Ddg%2BFHMy7CCph8HJvJRHrnwxLQIgOanKEyn9%2Bo1M2Ux%2FTqFXNo9GIguZfSvTxkZ4ODONHxwqvQUIAhACGgw5NjMxMzQyODk5NDAiDNmcz7mmWd%2ByHyWFXSqaBca2WeDmL0ylQGyAwWbHkxwYhnn9qCr3dXNfeV1UIGFwVVXFTW9J0x8l%2FobHjabimJrNoiuSio73%2BzbZwW7rlyRJpDeiY62uzWn7Tmm2A%2FAy2ChDr%2F%2B0u3rkWr3S9CD2%2Fh0cVlBCMPZCpxTK%2BJbHZoB%2F6TREBwts2XG%2BYOs7rW4fuPBfTFW22LKpXf1SxdA2BCkpcI4mat9907otV0ZLop9qCyCiF%2Belg7JccCC4fiHUITG9%2B4EXhCxvU9qYIDmgXFJaGkjfuwLJSxOPZ72u8vIXlpigJlR%2BDsPEy7VaJc3hoLumUK0wfKkKK9GSrx4tjtDEEa3m%2B2rgq9CISYMqLl2JR9DhBdoXf%2Fw%2F88rw%2FkFmW0ZDaff8WZpKafbCny5KHm4VD8uQvc6GMxULMI319N33AtRNeHv68PkBHXtiaCr9CHT30Pu4TL%2BYuEF%2BJHiBUQm3dSXnZ0MUoBA6F3fMcpeYUjXIuObf%2B2FKiY4rdKxDA%2BQ%2BpL6P2vgyhH7Pfmjn7S1H0yO%2B8bHWSHXSObzpezY1aPFowyWgn9QKjiYKfqZvCltLTUko1QQCj2zsNwVJnyL3RCME0E906K5n4fTgMz0hXegLW69MrNNg0dn4jPNN8cL5mS0D9Ge0qw4rVmZxgDRxWeRr0lzCUC3QXGN3rFchBIKCcUAL7P7UEGam5E2xOvgrDRJChfS6EODwMtnGY06xvELPC0KqQSZnXbpkMIKt1JIv1U5do%2BYE0uqEtU2Y%2Fgifb2a7MmdHpD%2BOZt4t8%2FjtryZCOXrayOsc7KoeBucESjdSsIWpBbOuSFJyIII4ck9TM2jnxmdjYlNtxWBOlLmmDka4y0stOlQz192O3eaipUWYvBLMtZnOnfMEF741RWEGFOQ2b0TwqDCer%2B%2FJBjqxAW4NnZodJUXY96PxpqFzqL6n1pL8JT2lQ4LVr8c4pftcXMAU7ouVfyQPSgVc2lwaSxkXUBj21zT50VxNK4fHtlyFFz4Lz3DTQCYNH%2BCq3PGxqXLTIN170tnl0CApuctAJHBWAwXJya3ZyxeI170LibMcV5TVp4DEYWKlKW7Ltn0zkR3ZFEL58x4ngXcc0qizg9%2FuxM3%2F1uhkmatbLC2l3IA6Io3jpmtXzXmvB%2FDe4Ls77w%3D%3D&X-Amz-Signature=f91775eb863f3dfd07444eb95f4ed876ec94f53814f1be3dfa6a20a0408a7c03&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)