Novel PEEK Retentive Elements versus Conventional Retentive Elements in Mandibular Overdentures: A Randomized Controlled Trial

M Y Sharaf, Asharaf Eskander, Mohamed Afify Afify, M Y Sharaf, Asharaf Eskander, Mohamed Afify Afify

Abstract

Background: Many patients suffer from lack of retention of conventional mandibular overdentures due to loss of clip retention over time. Computer-aided design-computer-aided manufacturing (CAD-CAM) milled polyether ether ketone (PEEK) materials may be used for the construction of retentive housing and clips for improving retention of implant-supported overdentures.

Objective: To compare retention and patient satisfaction of implant-supported mandibular overdentures retained by conventional nylon clip and metal housings for ball attachments versus PEEK clip and housings.

Methods: Twenty-two participants were divided into 2 equal groups (n = 11). The conventional group received implant-supported mandibular overdentures retained by metal housings and nylon retentive elements, while the PEEK group received implant-supported mandibular overdentures retained by PEEK retentive elements and housings. The PEEK retentive elements were made using computer-aided design and computer-aided manufacturing (CAD-CAM). The evaluation included measuring the retention by applying a gradual pulling up force by force meter and patient satisfaction with a 7-point visual analog scale (VAS) at overdenture insertion and 3, 6, and 12 months subsequently by a research interviewer.

Results: The PEEK group showed statistically significantly increased retention force (P < 0.05) at the time of insertion (37.6/17.79) and after 3 months (33.9/16.78), 6 months (32.7/15.97), and 12 months (31.65/13.05). The conventional group had a statistically significantly higher mean overall satisfaction (P < 0.05) at the time of insertion (65/82.18). No statistically significant difference was found after 3 months (87.81/84.72). The PEEK group showed statistically significantly higher mean overall satisfaction (P < 0.05) after 6 months (86.36/80.18) and 12 months (85.45/79.54).

Conclusions: According to the results of this study, the PEEK retentive material provided more retention than did the conventional material and led to improved patient satisfaction. The study was registered at clinical trials.gov (https://ichgcp.net/clinical-trials-registry/NCT05079048).

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Copyright © 2022 M. Y. Sharaf et al.

Figures

Figure 1
Figure 1
Checking parallelism between implants by the parallel pins.
Figure 2
Figure 2
Scanned image of ball abutment analog.
Figure 3
Figure 3
PEEK cap and ball abutment design.
Figure 4
Figure 4
PEEK cap adapted to ball abutment.
Figure 5
Figure 5
PEEK inserts attached to the ball abutment.
Figure 6
Figure 6
Fitting surface with picked up PEEK housing.
Figure 7
Figure 7
Fitting surface with picked up metal housing.
Figure 8
Figure 8
Flow diagram.

References

    1. ElKerdawy M. W., Radi I. A. W. Effect of dislodging forces on mandibular implant attachment-retained overdenture. Implant Dentistry . 2011;20(3):246–254. doi: 10.1097/id.0b013e318211fe1b.
    1. Büttel A. E., Lüthy H., Sendi P., Marinello C. P. Wear of ceramic and titanium ball attachments in subjects with an implant-retained overdenture: a controlled clinical trial. The Journal of Prosthetic Dentistry . 2012;107:109–113. doi: 10.1016/S0022-3913(12)60035-3.
    1. Fcinc J. S., Hehade A. C., Duncan W. J., et al. The McGill consensus statement on overdentures: mandibular two-implant overdentures as first choice standard of care for edentulous patients. Gerodontology . 2002;19(1):3–4.
    1. Nissan J., Oz-Ari B., Gross O., Ghelfan O., Chaushu G. Long-term prosthetic aftercare of direct vs. indirect attachment incorporation techniques to mandibular implant-supported overdenture. Clinical Oral Implants Research . 2011;22(6):627–630. doi: 10.1111/j.1600-0501.2010.02026.x.
    1. Yaseen A., Mohammed K. A. Comparison of two attachments retaining mandibular immediately loaded two implant overdentures. Cairo Dental Journal . 2012;28:1–7.
    1. Kronstrom M., Carlsson G. E. An international survey among prosthodontists of the use of mandibular implant-supported dental prostheses. Journal of Prosthodontics . 2017;28(2):e622–e626. doi: 10.1111/jopr.12603.
    1. Gosavi S. S., Ghanchi M., Anil Malik S., Sanyal P. A survey of complete denture patients experiencing difficulties with their Prostheses. The Journal of Contemporary Dental Practice . 2013;14:524–527.
    1. Abdulla Mardan N., Teodora Preoteasa C., Imre M., Maria Tancu A., Preoteasa E. Self-reported denture satisfaction in completely edentulous patients. Romanian Journal of Oral Rehabilitation . 2013;5:88–95.
    1. MacEntee M. I., Walton J. N., Glick N. A clinical trial of patient satisfaction and prosthodontic needs with ball and bar attachments for implant-retained complete overdentures: three-year results. The Journal of Prosthetic Dentistry . 2005;93(1):28–37. doi: 10.1016/j.prosdent.2004.10.013.
    1. Rutkunas V., Milzutani T. H. Influence of attachment wear on retention of mandibular overdenture. Journal of Oral Rehabilitation . 2007;34:41–51.
    1. El-Anwar M., El-Taftazany E., Hamed H., Abd ElHay M. Influence of number of implants and attachment type on stress distribution in mandibular implant-retained overdentures: finite element analysis. Open Access Macedonian Journal of Medical Sciences . 2017;5(2)
    1. Yang T.-C., Maeda Y., Gonda T., Kotecha S. Attachment systems for implant overdenture: influence of implant inclination on retentive and lateral forces. Clinical Oral Implants Research . 2011;22(11):1315–1319. doi: 10.1111/j.1600-0501.2010.02137.x.
    1. El-Charkawi G. Connecting implants to natural teeth. problems and solutions. implants and future. Proceedings of the 1st International Implantology Conference; 1995 March; p. p. 91.
    1. Brizuela A., Herrero-Climent M., Rios-Carrasco E., et al. Influence of the elastic modulus on the osseointegration of dental implants. Materials . 2019;12:980–987.
    1. Merk S., Wagner C., Stock V., et al. Retention load values of telescopic crowns made of YTZP and CoCr with Y-tzp secondary crowns: impact of different taper angles. Materials . 2016;9:p. 354.
    1. Zoidis P. Polyetheretherketone overlay prosthesis over high noble ball attachments to overcome base metal sensitivity: a clinical report. Journal of Prosthodontics . 2018;27(8):688–693. doi: 10.1111/jopr.12747.
    1. Zoidis P., Papathanasiou I., Polyzois G. The use of a modified poly-ether-ether-ketone (PEEK) as an alternative framework material for removable dental prostheses. a clinical report. Journal of Prosthodontics . 2016;25(7):580–584. doi: 10.1111/jopr.12325.
    1. Hahnel S., Wieser A., Lang R., Rosentritt M. Biofilm formation on the surface of modern implant abutment materials. Clinical Oral Implants Research . 2014;26(11):1297–1301. doi: 10.1111/clr.12454.
    1. Noiset O., Schneider Y.-J., Marchand-Brynaert J. Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata. Journal of Biomaterials Science, Polymer Edition . 2000;11(7):767–786. doi: 10.1163/156856200744002.
    1. Ohl A., Schröder K., Keller D., et al. Chemical micropatterning of polymeric cell culture substrates using low-pressure hydrogen gas discharge plasmas. Journal of Materials Science. Materials in Medicine . 1999;10:747–754. doi: 10.1023/a:1008943625715.
    1. Tetelman E. D., Babbush C. A. A new transitional abutment for immediate aesthetics and function. Implant Dentistry . 2008;17(1):51–58. doi: 10.1097/id.0b013e318167648c.
    1. Santing H. J., Meijer H. J. A., Raghoebar G. M., Özcan M. Fracture strength and failure mode of maxillary implant-supported provisional single crowns: a comparison of composite resin crowns fabricated directly over peek abutments and solid titanium abutments. Clinical Implant Dentistry and Related Research . 2012;14(6):882–889. doi: 10.1111/j.1708-8208.2010.00322.x.
    1. Bayer S., Komor N., Kramer A., Albrecht D., Mericske-Stern R., Enkling N. Retention force of plastic clips on implant bars: a randomized controlled trial. Clinical Oral Implants Research . 2012;23(12):1377–1384. doi: 10.1111/j.1600-0501.2011.02312.x.
    1. Tannous F., Steiner M., Shahin R., Kern M. Retentive forces and fatigue resistance of thermoplastic resin clasps. Dental Materials . 2012;28(3):273–278. doi: 10.1016/j.dental.2011.10.016.
    1. Stawarczyk B., Eichberger M., Uhrenbacher J., Wimmer T., Edelhoff D., Schmidlin P. R. Three-unit reinforced polyetheretherketone composite FDPs: influence of fabrication method on load-bearing capacity and failure types. Dental Materials Journal . 2015;34(1):7–12. doi: 10.4012/dmj.2013-345.
    1. Da Fontoura Frasca L., Castro Mattia P., Botega D., Rivaldo E. Evaluation of retention forces and resistance to fatigue of attachment systems for overdentures. Implant Dentistry . 2014;23:451–545. doi: 10.1097/id.0000000000000093.
    1. Fattore L., Malone W. F., Sandrik J. L., Mazur B., Hart T. Clinical evaluation of the accuracy of interocclusal recording materials. The Journal of Prosthetic Dentistry . 1984;51(2):152–157. doi: 10.1016/0022-3913(84)90251-8.
    1. Engelmeier R. L., Phoenix R. D. The development of lingualized occlusion. Journal of Prosthodontics . 2019;28:118–131. doi: 10.1111/jopr.12624.
    1. ELsyad M. A., Maryod W. H., Mostafa A. Z. Effect of implant position on clinical and radiographic outcomes of locator-retained mandibular overdentures: a 1-year prospective study. Journal of Prosthodontics . 2018;28(2):e699–e704. doi: 10.1111/jopr.12780.
    1. Chung K. H., Chung C. Y., Cagna D. R., Cronin R. J. Retention characteristics of attachment systems for implant overdentures. Journal of Prosthodontics . 2004;13(4):221–226. doi: 10.1111/j.1532-849x.2004.04042.x.
    1. Carlsson G. E., Omar R. The future of complete dentures in oral rehabilitation. a critical review. Journal of Oral Rehabilitation . 2010;37(2):143–156. doi: 10.1111/j.1365-2842.2009.02039.x.
    1. Evtimovska E., Masri R., Driscoll C. F., Romberg E. The change in retentive values of locator attachments and hader clips over time. Journal of Prosthodontics . 2009;18(6):479–483. doi: 10.1111/j.1532-849x.2009.00474.x.
    1. Ettinger R. L., Qian F. Longitudinal assessment of denture maintenance needs in an overdenture population. Journal of Prosthodontics . 2018;28(1):22–29. doi: 10.1111/jopr.12735.
    1. Alsabeeha N. H, Payne A. G., Swain M. V. Attachment systems for mandibular two-implant overdentures: a review of in vitro investigations on retention and wear features. The International Journal of Prosthodontics . 2009;22:429–440.
    1. Rutkunas V., Mizutani H., Takahashi H. Evaluation of stable retentive properties of overdenture attachments. Stomatologiia . 2005;7:115–120.
    1. Sharaf M., Bakry E., Abdall M. A comparison of the retentive force of ball and socket attachment versus magnet attachment in mandibular overdentures: a randomized control trial. Journal of International Oral Health . 2020;12(5):420–426. doi: 10.4103/jioh.jioh_20_20.
    1. Schweyen R., Beuer F., Arnold C., Hey J. Retentive characteristics of a vinylpolysiloxane overdenture attachment system. Clinical Oral Investigations . 2015;19(4):947–953. doi: 10.1007/s00784-014-1307-1.
    1. Al-Omiri M. K., Karasneh J. Relationship between oral health-related quality of life, satisfaction, and personality in patients with prosthetic rehabilitations. Journal of Prosthodontics . 2010;19:2–9.

Source: PubMed

3
구독하다