Polyetherketoneketone (PEKK) is a new evolving polymeric material. The present article comprehensively reviewed an overview of various applications of PEKK in prosthodontics and oral implantology, highlighting its prospects for clinical applications. PEKK biomaterials is an elastic material with good shock absorbance and fracture resistance and present ultra-high performance among all thermoplastic composites for excellent mechanical strength, chemical resistance, and high thermal stability. Available articles on PEKK for dental applications were reviewed from January 1957 to August 2020) using MEDLINE/PubMed, Web of Science, and ScienceDirect resources. PEKK presents suitable physical, mechanical, and chemical properties for applications in prosthodontics and oral implantology. PEKK has good potential for a wide range of dental applications, including tooth restorations, crowns, bridge, endoposts, denture framework, implant-supported fixed prosthesis, and dental implants. PEKK dental implants have shown lesser stress shielding compared to titanium for dental implant applications. Further modifications and improving material properties can result in broader applications in the field of dentistry. Long term evaluations are needed as PEKK is recently applied in dentistry, and there are limited studies published on PEKK.

This study aimed to compare the surface roughness, hardness, and flexure strength of interim indirect resin restorations fabricated with CAD-CAM (CC), 3D printing (3D), and conventional techniques (CV). Twenty disk (3 mm × Ø10 mm) and ten bar specimens (25 × 2 × 2 mm) were fabricated for the CC, 3D, and CV groups, to be used for surface roughness, micro-hardness, and flexural strength testing using standardized protocol. Three indentations for Vickers micro-hardness (VHN) were performed on each disk and an average was identified for each specimen. Surface micro-roughness (Ra) was calculated in micrometers (μm) using a 3D optical non-contact surface microscope. A three-point bending test with a universal testing machine was utilized for assessing flexural strength. The load was applied at a crosshead speed of 3 mm/min over a distance of 25 mm until fracture. Means and standard deviations were compared using ANOVA and post hoc Tukey–Kramer tests, and a p-value of ≤0.05 was considered statistically significant. Ra was significantly different among the study groups (p < 0.05). Surface roughness among the CC and CV groups was statistically comparable (p > 0.05). However, 3D showed significantly higher Ra compared to CC and CV samples (p < 0.05). Micro-hardness was significantly higher in 3D samples (p < 0.05) compared to CC and CV specimens. In addition, CC and CV showed comparable micro-hardness (p > 0.05). A significant difference in flexural strength was observed among the study groups (p < 0.05). CC and 3D showed comparable strength outcomes (p > 0.05), although CV specimens showed significantly lower (p < 0.05) strength compared to CC and 3D samples. The 3D-printed provisional restorative resins showed flexural strength and micro-hardness comparable to CAD-CAM fabricated specimens, and surface micro-roughness for printed specimens was considerably higher compared to CAD-CAM and conventional fabrication techniques.

Cytomorphometry is used in the sampling of biological materials and diagnostic procedures. The use of cytological studies in periodontal diseases is not well described in the literature. Our study aimed to quantitatively assess the inflammation dynamics using cytomorphometric analysis of the periodontium before and after the use of fixed dental prostheses. Following ethics approval, a total of 105 subjects were divided in 3 groups as gingivitis (n = 23), periodontitis (n = 58), and healthy periodontium (control) (n = 24). The fixed dental prostheses (crowns and fixed partial dentures) were fabricated from cobalt-chrome metal-ceramic prostheses using the conventional method (C/M-CoCr), cobalt-chrome metal-ceramic prostheses by the computer-aided design and computer-aided manufacturing (CAD/CAM) technique (C/C-CoCr), and zirconia-based ceramic prostheses by the CAD/CAM technique (C/C-Zr) among subjects with gingivitis and periodontitis. The gingival crevicular fluid (GCF) was obtained from subjects before and after the use of the prostheses. The total count of epithelial cells and the connective tissue cells or polymorphonuclear neutrophils (PMNs) in GCF were studied using cytomorphometric analysis. The Statistical Package Tor the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA) was used to analyze the results and the significance level was set at p = 0.05. The data for before and after the use of the prostheses were compared using independent t-Tests. Similarly, the results after the use of prostheses in gingivitis, periodontitis, and control in each type of prostheses were compared using One-way ANOVA with post hoc using Scheffe. The total epithelial cells and the PMNs were determined along with the epithelium/leukocyte index. Regardless of the prostheses type used, no significant change in the parameters was identified among patients with a healthy periodontium, before and after prosthetic treatment. In all study groups, a statistically increase (p value < 0.05) was observed in the oral epithelial cell counts and a statistically decrease (p < 0.05) in the PMNs count following the use of the fixed prostheses. Data on cytomorphometric analysis could enable the selection of the most appropriate prostheses for use in patients with periodontal pathologies. When choosing prostheses, changes in the composition of GCF could be considered as a useful criterion for their use.