Influência de diferentes tratamentos de superfície na resistência de união entre PEEK e materiais de revestimento estético: revisão sistemática e meta-análise

Abstract

Polyether-ether-ketone (Polyetheretherketone - PEEK) is a polymer with excellent mechanical properties, which makes it a potential candidate to replace metallic alloys in several dental specialties. When used as an infrastructure for the manufacture of dental prostheses, the adhesion of PEEK to the aesthetic coating material is decisive for the longevity of the treatment, although the low surface energy and great chemical stability of the polymer make this adhesion a challenge to be overcome. Objective: Answer the question: “Do other PEEK surface treatments generate bond strengths superior to commercial adhesive?” Methods: The search was carried out in the Pubmed, LILACS, Scopus, Web of Science, and EMBASE, ProQuest and Google Scholar databases in June 2023 and there were no restrictions regarding the language or publication date of the studies. The following terms and bolean operators were used: "polyether ether ketone" [MH] OR "polyether ether ketone" OR "polyetheretherketone" OR "polyetherketoneketone" OR "PEEK" AND "shear strength" [MH] OR "shear strength" OR " shear bond strength" OR "tensile bond strength" OR "shear" OR "tensile" OR "microtensile" OR "microshear" OR "bonding" OR "bond strength" OR "microtensile strength" OR "microshear bond strength" OR "bond" OR "adhesion" OR "bond integrity" OR "bonded" OR "Bonding Strength" OR "Bonding Behavior" OR "Adhesive Performance" OR "surface bonding" OR "tensile strength" [MH] OR "tensile strength". Only in vitro studies were included. Composite resins and acrylic resins were considered as coating materials for PEEK. The mean and standard deviation expressed in MPa and obtained from shear and tensile tests were used to report the bond strength between PEEK and coating materials. Meta-analyses were performed and the Cochrane Collaboration tool assessed the risk of bias (RoBDEMAT). Results: 23 studies were selected. The bond strength between PEEK and composite resin was favored by the use of the adhesive (P<0,00001), regardless of the type of adhesive. Pretreatment with Al2O3 sandblasting (P<0,00001), sulfuric acid (P<0,00001), cold plasma (P=0,0006) and laser (P<0,00001) proved to be efficient, although conditioning with piranha solution did not have a statistically significant effect (P=0,47). Conclusion: The application of sulfuric acid before the adhesive showed better results in bond strength compared to the use of the adhesive alone.