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Creo iP

Creo iP is a restoration that utilizes the advantages of PEEK, a semi-crystalline linear polycyclic aromatic polymer that became a high-performance thermoplastic candidate for replacing metal implant components. Because of its color, it is not suitable for monolithic esthetic restorations of anterior teeth; an e.max crown or composite coating should be used instead.

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  • PEEK is a semi-crystalline linear polycyclic aromatic polymer. In 1978, it was developed by a group of English scientists. Later PEEK was commercialized for industrial applications. By the late 1990s, PEEK became an important high-performance thermoplastic candidate for replacing metal implant components.

  • Due to the grayish-brown color of PEEK, it’s not suitable for monolithic esthetic restorations of anterior teeth. Hence more esthetic material like e.max crowns or composite should be used as a coating to get an aesthetic result. Many surface conditioning methods of PEEK to improve bonding with individual crowns of lithium disilicate or resin composite crowns has been suggested.

  • Due to its favorable mechanical, physical properties, PEEK is used in producing fixed and removable prostheses.

    • Light weight: PEEK with its low specific weight can be used to construct very lightweight prosthesis which will provide high patient satisfaction and comfort.
    • Convenience for repair: When some fracture or chipping takes place on the crowns, the repair is simple and convenient relative to other prostheses because it can be repaired or replaced individually.
    • Minimize stress shielding of implant: The tensile properties of PEEK are analogous to bone, enamel and dentin. Thus, this material can exhibit less stress shielding effect compared to other metallic materials. Undetectable incongruity will be compensated for by the elasticity of the PEEK, and not transferred to the implants or the bone.

Validations

Cumulative Survival Rate

The registered 100% implant cumulative survival rate (CSR) of the present study is comparable to recent publications for the All-on-4 concept. Maló et al. (2019) reported three-year CSR of 97.8% and 99.1% for the maxilla and mandible. Furthermore, a systematic review evaluating the All-on-4 treatment concept registered a 99.8% implant CSR for All-on-4 restorations with a follow-up of two or more years.

Marginal Bone Loss

The mean marginal bone loss (MBL) at three years of follow-up demonstrated the stability of the rehabilitations over this period, as compared to the difference of 0.03 mm of mean MBL registered in the previous one-year report. Moreover, the MBL recorded in the present study at three years compares favorably with previous studies reporting a range of 1.06–1.52 mm for the maxilla and 1.30 mm overall for both maxilla and mandible. In a systematic review comparing marginal bone loss between axial and tilted implant-supported fixed prosthetic reconstructions, a range of 0.91–1.55 mm and 0.72–1.67 mm was registered after three years of follow-up of full-arch restorations for axial and tilted implants, respectively (data extracted from study). The potential explanation of this lower MBL could be associated with PEEK’s characteristics of shock absorption, given its 1200 N cut-off point for plastic deformation (important in load-bearing areas).

-Nobre et al., Hybrid Polyetheretherketone (PEEK)–Acrylic Resin Prostheses and the All-on-4 Concept: A Full-Arch Implant-Supported Fixed Solution with 3 Years of Follow-Up, J of Clin. Med., 2020.

Requirements

  • Minimum height of substructure needs to be 7-10mm, width 5-8mm and can contain cantilevers which can be no longer than the length between the two neighboring implants

Indications

  • Multi-unit implant-supported bridge

  • Full arch implant rehabilitation

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