Comparative evaluation of BioHPP and titanium as a framework veneered with composite resin for implant-supported fixed dental prostheses

Abstract Statement of problem High rates of veneering chipping are a common prosthodontic complication of restorations with a titanium framework. A new bio high-performance polymer (BioHPP) based on polyetheretherketone (PEEK) has been introduced for denture superstructures. Clinical reports suggest that BioHPP could be used as an alternative framework material to support complete-arch restorations. However, peer-reviewed information is lacking regarding the performance of BioHPP as a framework material for implant-supported screw-retained fixed dental prostheses (FDPs) veneered with composite resin. Purpose The purpose of this in vitro study was to evaluate and compare the bond strength of modified PEEK (BioHHP) and titanium with a veneering composite resin and compare the marginal fit and fracture resistance of implant-supported screw-retained FDPs fabricated by using computer-aided design and computer-aided manufacturing (CAD-CAM) frameworks veneered with composite resin. Material and methods A composite resin was bonded to 2 framework materials (n=20/group): pure titanium (Ti) and BioHPP (Bi). The shear bond strength (SBS) was determined after 24-hour wet storage. Furthermore, 20 3-unit CAD-CAM BioHPP and titanium frameworks were fabricated (n=10/group). The marginal fit between frameworks and abutments was evaluated by scanning electron microscopy by using the single-screw test. After thermocycling and mastication simulation, the fracture resistance of FDPs veneered with the composite resin was examined. The independent sample t test was used to evaluate differences (α=.05). Results Significantly higher shear bond strengths were obtained in group Bi (31.1 ±3.5 MPa) than in group Ti (20.5 ±1.8 MPa). The mean marginal gap width was 19 ±4 μm in group Bi and 16 ±6 μm in group Ti. Statistical tests showed no significant differences ( P >.05). After loading, veneering chipping was observed at a load of 1960 ±233 N in group Ti. Although the BioHPP frameworks fractured at 1518 ±134 N, no chipping occurred. Conclusions The bond strength of BioHPP with the composite resin was greater than that of titanium. CAD-CAM BioHPP frameworks exhibit good marginal fit and fracture resistance. BioHPP may be a suitable alternative to metal as a framework to be veneered with composite resin.