Evaluation of stresses on mandible bone and prosthetic parts in fixed prosthesis by utilizing CFR-PEEK, PEKK and PEEK frameworks

Fixed prostheses are appropriate treatment solutions for edentulous patients. In fixed prostheses, following "All on four", titanium frameworks are commonly used to support the implants. However, the limitations of titanium have prompted researchers to search for alternative materials (e.g. polymers). This study applied finite element investigation to evaluate the stress distribution in the parts of fixed prosthesis and the surrounding bone tissue, using polymeric frameworks in place of titanium, and different densities of spongy bone. As, the success of fixed prosthesis was predicted to be influenced also by bone quality, particularly spongy bone density. Fixed prosthesis was constructed on edentulous mandible, then different frameworks (CFR-PEEK 60%, CFR-PEEK 30%, PEKK, and PEEK) were stimulated instead of titanium, under 300N unilateral and bilateral forces. Three densities of spongy bone were stimulated which are normal, low and high. The choice of framework material depended on the density of spongy bone. Moreover, PEEK framework showed the lowest stress values on bone tissues and the highest stress values on mucosa. All frameworks could be used in the fixed prosthesis, in the cases of normal and high densities of spongy bone. In low-density case, soft frameworks (PEKK and PEEK) were recommended to reduce the stresses generated on bone tissues.