Applications, modifications, and manufacturing of polyetheretherketone (PEEK) in dental implantology: A comprehensive critical review

Polyetheretherketone (PEEK), a thermoplastic polymer from the polyaryletherketone (PAEK) family, is increasingly used in dental biomedical applications because of its bioinert properties. This comprehensive review examines PEEK's suitability as a dental implant fixture and other related prostheses, focusing on its mechanical stability, chemical resistance, and compatibility with human bone. PEEK's ability to distribute and transmit occlusal forces to surrounding bone, along with its aesthetic advantages, make it a promising implant material that outperforms titanium and zirconia. PEEK has been successfully employed in various dental implantology applications, including implant fixtures, abutments, scan bodies, abutment screws, and implant-supported superstructures such as frameworks, crowns, and bridges, as well as overdenture attachment components. As a dental implant fixture, PEEK has undergone several modifications to enhance its surface, mechanical, and biological properties. PEEK exhibits comparable mechanical strength to other materials but offers advantages such as reduced production times and costs, improved toughness, and recyclability. Its non-interference with MRI and CBCT enhances diagnostic capabilities, while bioactive substances like hydroxyapatite further enhance its dental applications. Several manufacturing methods are available, each with specific advantages and limitations. Computer Numerical Control (CNC) milling is commonly used in dental labs but leads to material waste and tool wear challenges. Advances in micro-milling and cutting tool technology enable finer detail in PEEK parts. Additionally, 3-D printing is emerging as a promising technology for more precise and efficient dental part production. This review aims to update the current knowledge about PEEK applications, modifications, and manufacturing in the field of dental implantology. Moreover, it explores the challenges and suggests future research directions for optimising PEEK's bioactivity and stress distribution.