Title Polyetheretherketone (PEEK) Implants are Less Successful than Titanium Implants
Clinical Question For patients receiving dental implants, will a PEEK implant show similar osseointegration and success rates as titanium implants?
Clinical Bottom Line Dental implants fabricated from PEEK have not shown clinical success equivalent to that of titanium dental implants. A systematic review of five in vitro and four animal studies showed that PEEK implants, regardless of implant surface modification, had a significantly lesser degree of osseoconductivity and bioactivity than did titanium implants. Dentists should continue to use titanium implants until further PEEK bioactivity research is conducted and this material is shown to have properties similar or superior to that of titanium.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
27560166Najeeb/20165 in vitro studies, 4 animal studies (6 dogs, unknown number of rabbits, 32 rats, 18 sheep)Systematic review of non-randomized trials
Key resultsIn four of the five in vitro studies, more cellular proliferation, blood vessel growth, and bone growth occurred with titanium implants than PEEK implants. In the animal studies, titanium implants, regardless of surface treatment, showed more bone growth than did PEEK implants without a surface treatment; however, hydroxyapatite-coated PEEK implants showed similar bone-implant contact as coated titanium implants.
Evidence Search (((PEEK) AND polyetheretherketone) AND dental implant) AND titanium [Filters: Systematic Reviews]
Comments on
The Evidence
Validity: It is reasonable to call this evidence valid because of the study models in human bone tissue in vitro and animal studies. We might say that the evidence is weak, as it is not a systematic review of randomized controlled trials and is lacking a meta-analysis. In addition, the authors noted that the human tissue studies were carried out over a short period of time and are not indicative of a clinical setting. For stronger evidence, we would also like to see not only more animal studies comparing PEEK to titanium, but also studies with better design, as the studies included did not mention randomization or blinding. Perspective: Much of dental implant research starts with animal studies and in vitro studies before in vivo human studies are performed.
Applicability Implant loss and peri-implantitis are always risks of dental implant placement. PEEK is an up-and-coming biomaterial in the dental field. It has been used successfully in orthopedics, trauma, and manufacturing for decades. It is now making a push into dentistry for uses such as crowns, FDPs, frameworks, and possibly dental implants. However, PEEK dental implants, at this time, are at a much higher risk of peri-implantitis and implant loss. Patients expect an implant to be successful. A PEEK implant will not meet patient expectations.
Specialty (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Polyetheretherketone, PEEK, dental implant
ID# 3340
Date of submission 11/15/2018
E-mail bartoa@uthscsa.edu
Author Aaron W. Barto, DDS
Co-author(s) e-mail
Faculty mentor Matthew Lamb, DDS
Faculty mentor e-mail LambEM@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available