title: Bioactivity and Osseointegration of PEEK Are Inferior to Those of Titanium: A Systematic Review.
abstract: Polyetheretherketone (PEEK) has been suggested as an alternative to replace titanium as a dental implant material. However, PEEK's bioactivity and osseointegration are debatable. This review has systematically analyzed studies that have compared PEEK (or PEEK-based) implants with titanium implants so that its feasibility as a possible replacement for titanium can be determined. The focused question was: "Are the bioactivity and osseointegration of PEEK implants comparable to or better than titanium implants?" Using the key words "dental implant," "implant," "polyetheretherketone," "PEEK," and "titanium" in various combinations, the following databases were searched electronically: PubMED/MEDLINE, Embase, Google Scholar, ISI Web of Knowledge, and Cochrane Database. 5 in vitro and 4 animal studies were included in the review. In 4 out of 5 in vitro studies, titanium exhibited more cellular proliferation, angiogenesis, osteoblast maturation, and osteogenesis compared to PEEK; one in vitro study observed comparable outcomes regardless of the implant material. In all animal studies, uncoated and coated titanium exhibited a more osteogenic behavior than did uncoated PEEK, while comparable bone-implant contact was observed in HA-coated PEEK and coated titanium implants. Unmodified PEEK is less osseoconductive and bioactive than titanium. Furthermore, the majority of studies had multiple sources of bias; hence, in its unmodified form, PEEK is unsuitable to be used as dental implant. Significantly more research and long-term trials must focus on improving the bioactivity of PEEK before it can be used as dental implant. More comparative animal and clinical studies are warranted to ascertain the potential of PEEK as a viable alternative to titanium.
authors: 1   Restorative Dental Sciences, Al-Farabi College, Al Khaleej, King Abdullah Road, Riyadh, Saudi Arabia.
authors: Shariq
authors: S
authors: Najeeb
authors: 2   Department of Prosthodontics and Implantology, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia.
authors: Zohaib Khurshid
authors: ZK
authors: Bds
authors: 3   Department of Biomedical Engineering, King Faisal University, Al Hofuf, Saudi Arabia.
authors: Sana Zohaib
authors: SZ
authors: Bds
authors: 4   Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia.
authors: Muhammad Sohail Zafar
authors: MS
authors: Bds
mesh_terms: D000818:Animals; D001577:Benzophenones; D015921:Dental Implants; D007659:Ketones; D016348:Osseointegration; D011092:Polyethylene Glycols; D011108:Polymers; D014025:Titanium
chemical_list: D001577:Benzophenones; D015921:Dental Implants; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium
keywords: bioactivity; osseointegration; polyetheretherketone; titanium