• Journal of Technologic Dentistry
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• v.46 no.1
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• pp.15-19
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• 2024

An ideal post material should have physical properties similar to those of dentin. Post materials with high elastic moduli may cause root fractures. This clinical report describes the treatment of a severely damaged tooth using a recently introduced material. Polyetherketoneketone (PEKK) is a semicrystalline high-performance thermoplastic polymer. PEKK is a promising material for custom post-and-core fabrication because of its elasticity close to that of dentin, good shock absorbance, machinability, and low cost. A laboratory scanner was used to digitize the conventional impression of a severely damaged maxillary right first molar. A custom PEKK post-and-core was designed and milled using computer-aided design and computer-aided manufacturing technology. Using the proposed technique, a custom PEKK post-and-core was fabricated accurately and human error was reduced. Restoration was luted with resin cement. Custom PEKK post-and-core restorations are a viable alternative for treating severely damaged teeth.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.1
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• pp.20-27
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• 2024

As a high-performance polymer, Polyetherketoneketone (PEKK) has good biocompatibility and excellent physical properties and is used in several areas, including dentistry. Many successful cases of implant-supported fixed prostheses with a PEKK framework have been reported; however, a long-term observation of the reported cases and discussion of complications are not available. In this case report, we present three cases of implant-supported fixed prostheses with a PEKK framework veneered with composite resin, lithium disilicate crown, and high-impact polymethyl methacrylate (PMMA), and discuss their 6-year follow-up results.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.1
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• pp.1-11
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• 2020

Purpose: The purpose was to compare shear bond strength (SBS) of three types of resin for temporary restoration to polyetherketoneketone (PEKK) depending on surface modification. Materials and Methods: Sixty disks made from PEKK were air-abraded with 110 ㎛ alumina particles (Cobra, Renfert GmbH, Hilzinge, Germany) and thirty specimens were divided into two groups each: PEKK without Visio.link (Bredent, Senden, Germany)(U) and with Visio.link (P). Resins for temporary restoration (polymethylmethacrylate; PMMA, polyethylmethacrylate; PEMA, bis-acryl composite resin) in the shape of a square with one side 3.2 mm were bonded to PEKK twenty respectively and classified into six groups (UM, UE, UC, PM, PE and PC). All specimens were stored in distilled water at 37℃ for 24 hours. SBS of each group was measured at a crosshead speed of 2 mm/min in universal testing machine. SBS was compared using one-way ANOVA and a Tukey HSD test (P = 0.05). Results: Group UM and group UE showed a significant difference in SBS with group UC (P < 0.05). Group PC showed a significant increase in SBS than group UC (P < 0.05). Conclusion: It is recommended to apply Visio.link to PEKK for adhering bis-acrylic composite resin, but not for PMMA and PEMA in clinical practice.

• The Journal of Advanced Prosthodontics
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• v.10 no.6
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• pp.408-414
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• 2018

PURPOSE. This study aimed to assess the effect of non-thermal plasma on the shear bond strength of resin cements to polyetherketoneketone (PEKK) in comparison to other surface treatment methods. MATERIALS AND METHODS. Eighty PEKK discs were subjected to different surface treatments: (1) Untreated (UT); (2) Non-thermal plasma (NTP); (3) Sandblasting with $50{\mu}m$ $Al_2O_3$ particles (SB); and (4) Sandblasting + Non-thermal plasma (SB+NTP). After each surface treatment, the contact angle was measured. Surface conditioning with Visio.Link was applied in all groups after pre-treatment. RelyX Unicem resin cement was bonded onto the PEKK specimens. After fabrication of the specimens, half of each group (n=10) was initially tested, while the other half was subjected to thermocycling ($5^{\circ}C$ to $55^{\circ}C$ at 10,000 cycles). Shear bond strength (SBS) testing was performed using a universal testing machine, and failure modes were assessed using stereomicroscopy. The SBS results were analyzed statistically using one-way ANOVA followed by Tukey's post hoc test. Independent t-test was used to examine the effect of thermocycling (P<.05). RESULTS. The highest SBS values with or without thermocycling were observed with PEKK specimens that were treated with SB+NTP followed by the SB group. The lowest SBS results were observed in the UT groups. CONCLUSION. The shear bond strength between PEKK and resin cements was improved using non-thermal plasma treatment in combination with sandblasting.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.254-262
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• 2022

When treating partial edentulous patients, it is important to use an appropriate restorative materials. Inappropriate restorative materials can adversely affect the outcome of prosthetic restorations. Zirconia and dental metal, which are currently and widely used materials, have a higher elastic modulus than cortical bone, so when an external force is generated, a harmful force can be applied to the implant and the bone around the implant. Polyetherketoneketone (PEKK), a recently introduced material, has a elastic modulus similar to that of cortical bone, and has many advantages in terms of physical properties and biocompatibility. This case report describes that implant-supported fixed prosthetic treatment using PEKK was performed, and functional and esthetic satisfactory results were obtained.

• Journal of Technologic Dentistry
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• v.45 no.3
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• pp.61-66
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• 2023

Purpose: The current study examined the retention and wear resistance of stud-type attachments made of high-performance polyetheretherketone (PEEK) or polyetherketoneketone (PEKK) from the polyaryletherketones (PAEKs) family. Methods: The study sample included 10 PEEK or PEKK attachments that were mounted onto their male parts, designed on the upper aspect of the attachment, with a load of 30 N. Tensile stress was applied using an Instron machine to separate the male and female parts, and the maximum tensile stress to be applied was determined based on the retention force observed. The wear resistances of PEEK and PEKK were evaluated by measuring the inner diameter of the inserted female part 10 times. Results: The maximum tensile stresses of PEEK and PEKK were 56.26±0.58 and 69.12±0.92 N, respectively, with the maximum stress required to remove the PEKK specimens from the abutment being 12.86 N higher than that required to remove the PEEK specimens. Furthermore, PEKK exhibited higher wear resistance than PEEK. Conclusion: This study evaluated custom-made removable implant-retained attachment components for overdentures, wherein the female parts were made of PEEK or PEKK. The retention stress and wear resistance were evaluated based on the type of attachment material, and the results showed that both types of attachment inserts demonstrated clinically acceptable results in terms of retention.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.3
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• pp.207-216
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• 2020

Purpose: To compare the polishing characteristics and their influence on Candida albicans adhesion to the recently introduced polyetherketoneketone (PEKK) and the conventional polymethylmethacrylate (PMMA) denture resin material. Materials and methods: Specimens from PEKK (Group E) and PMMA (Group M) were made in dimensions of 8 mm in diameter and 2 mm in thickness. The specimens were further divided into sub-groups according to the extent of polishing (ER, MR: rough; EP, MP: polished, N = 12 each). The specimens were polished using polishing machine and SiC foil. ER and MR group specimens were polished with 600 grit SiC foil only. EP and MP groups were further polished with 800, 1,000, 1,200 grit SiC foils sequentially. To measure the surface roughness values (Sa) of specimens, atomic force microscope (AFM) was used and scanning electron microscope (SEM) observation under 1,000, and 20,000 magnifications was performed to investigate surface topography. The polished specimens were soaked in C. albicans suspension for 2 hours with shaking to promote adhesion. The attached C. albicans were detached from the surface with 10 times of pipetting. The suspension of detached C. albicans was performed by serial dilution to 10³ times, and the diluted suspensions were inoculated on Sabouraud dextrose agar plates using spread plate method. After incubating the plate for 48 hours, colony forming unit (CFU)/plate of C. albicans was counted. Statistical analysis was performed using one-way ANOVA and Tukey HSD test to confirm significant difference between the groups (α=.05). Results: Average Sa value was significantly higher in MR group compared to other groups (P<.05), meaning that additional polishing steps reduced surface roughness effectively only in the PMMA specimens. There was no significant difference in Sa values between MP and EP groups. In SEM images, PEKK specimens showed numerous spikes of abraded material protruding from the surface and this phenomenon was more significant in EP group. The mean CFU/plate value was the highest in EP group and this was significant when it was compared to MP group (P<.05) which was the lowest. Conclusion: Polishing PEKK using serial SiC abrasive foil may result in higher adhesion of C. albicans. In clinic, this should be considered carefully.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.231-238
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• 2022

Purpose. This study aimed to investigate the effect of different veneering methods on the tensile bond strength between polyetherketoneketone (PEKK) and denture base resins. Materials and methods. A total of 80 PEKK T-shaped specimens were fabricated and the primer (Visio.link) was applied after airborne-particle abrasion with 110 ㎛ alumina oxide powder. According to the veneering method, the specimens were divided into four groups (n = 20) to be veneered with the gingival colored packable photopolymerized composite resin (SR Adoro); flowable photopolymerized composite resin, (Crea.lign); heat-polymerized resin (Vertex); and self-polymerized resin (ProBase Cold). Each group was divided into two subgroups (n = 10) according to the artificial thermal aging. After the tensile bond strength measurement via universal testing machine, the fracture sections of all specimens were observed. Two-way ANOVA and Tukey's HSD post hoc test were used for the statistical analysis (α = .05). Results. The results of the two-way ANOVA showed statistically significant differences in the tensile bond strength according to the veneering method and artificial thermal aging of denture base resins (P<.001). The highest tensile bond strength showed in the packable photopolymerized resin group before and after the artificial thermal aging. The lowest tensile bond strength showed in the heat-polymerized resin group. The mixed and adhesive fracture showed in all groups. Conclusion. The veneering method and artificial thermal aging can influence in the tensile bond strength between the resin and PEKK. The artificial thermal aging can reduce the tensile bond strength.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.305-310
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• 2017

Nowadays, the development of dental scanner and CAD/CAM technology can facilitate the fabrication of hybrid prosthesis. Double scanning technique, scanning a trial prosthesis and master model, made it possible to realize virtual design and simplify the laboratory work. Instead of using the metal or zirconia framework with composite, ceramic or denture tooth, the new high performance polymer Polyetherketoneketone (Pekkton, Cendres+$M{\acute{e}}taux$, Biel, Switzerland) as a framework with Polymethyl methacrylate (PMMA) veneering teeth (Visio-lign, Bredent, Senden, Germany) was used in this case. This case report showed an acceptable treatment outcome and satisfaction of patient using Pekkton and Visio-lign. However, long term clinical evaluation is needed.

• Composites Research
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• v.35 no.2
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• pp.86-92
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• 2022

This study was conducted to determine the effect of molecular formation of adhesive on interface characterization of thermoplastic composites. Carbonfiber/polyetherketoneketone (CF/PEKK) thermoplastic composites were fusion bonded and PEEK, PEI adhesive bonded using a high-temperature oven welding process. In addition, lap shear strength test and fracture surface analysis using a digital optical microscope and a scanning electron microscope (SEM), and Fourier transform infrared spectroscopy (FTIR) were performed. As a result, the adhesive bonding method improved adhesion strength with interphase having increased molecular formation of ether groups, ketone groups, and imide groups which mainly constitutes the CF/PEKK and adhesives. Furthermore, it was found that the use of PEEK containing more ether groups and ketone groups forms a more strongly bonded interphase and enhances the adhesive force of the CF/PEKK composites.