Can PEEK and PEKK Replace Metal Frameworks in Full-Arch Implant Prostheses?

Published in Evidence-Based Dentistry — September 2023. Co-authored by Sunil Kumar Mishra, Dr. B. Srinivas Rao, and Ramesh Chowdhary.

When a patient receives a full set of dental implants supported permanent teeth, the prosthesis needs an internal framework — a structural skeleton that holds everything together. Traditionally, these frameworks have been made from metals like titanium or cobalt-chromium alloys. They are strong and well-proven, but they add weight, can sometimes cause aesthetic concerns, and in rare cases may trigger metal sensitivity.

In recent years, a new class of high-performance polymers has emerged as a potential alternative — PEEK (polyetheretherketone) and PEKK (polyetherketoneketone). These materials are lightweight, metal-free, and have mechanical properties closer to natural bone, which theoretically means they absorb and distribute chewing forces in a more biomimetic way.

But are they actually reliable enough for full-arch implant prostheses? That is the question Dr. Srinivas and his co-authors set out to answer in this systematic review.

What the Review Examined The team followed the PRISMA guidelines — the gold standard methodology for systematic reviews — to identify and analyse all available clinical studies reporting on complete-arch [dental implants](/services/dental-implants) supported fixed dental prostheses fabricated with PEEK or PEKK frameworks.

The review evaluated key clinical outcomes including framework fracture rates, prosthetic complications, marginal bone loss around the supporting implants, patient satisfaction, and the overall survival rate of the prostheses over time.

Key Findings The evidence showed that PEEK and PEKK frameworks demonstrated promising short-term clinical performance. Their shock-absorbing properties may help reduce the mechanical stress transmitted to implants and the surrounding bone — a potential advantage over rigid metal frameworks, particularly in patients who clench or grind their teeth.

However, the review also found that long-term clinical data remains limited. Most available studies had relatively short follow-up periods, and the number of patients studied was small. While the early results are encouraging, the authors concluded that more large-scale, long-term clinical trials are needed before PEEK and PEKK can be recommended as a routine replacement for metal frameworks.

What This Means for Patients If you are considering [full mouth rehabilitation](/services/full-mouth-rehabilitation) with implants at Maxface Dental Clinic, Dr. Srinivas can discuss whether a traditional metal framework or a newer polymer-based option is more appropriate for your specific situation. His involvement in this systematic review means he has first-hand knowledge of the latest evidence on these emerging materials — ensuring your treatment plan is based on science, not trends.

For patients with known metal allergies or sensitivity, PEEK-based prostheses may offer a genuinely metal-free solution worth exploring.

About the Publication Journal: Evidence-Based Dentistry

Published: September 2023

Type: Systematic Review

Read the original publication on ResearchGate.