Evaluation of Bond Strength of Veneering Composite to Polyetherketoneketone (PEKK): A Systematic Review

Abstract

Abstract Aim: To evaluate the bond strength between veneering composite and polyetherketoneketone (PEKK) and to examine the effect of different surface treatments this bond strength. Materials and Methods: The study is registered in PROSPERO database with the registration number CRD42024514610. Eligible studies included randomized trials, case–control and cohort studies, in vitro studies, and human studies published in English. A PRISMA-guided search was done on PubMed, Cochrane, Web of Science, ProQuest, and Scopus for data collection. A total of 162 records were identified, out of which 93 were screened. Full-text assessments were performed on 15 studies, and finally, 6 studies were included in the review. Risk of bias assessment was done using the Timmers RoB tool. Characteristics and results of the included studies were analyzed. Good shear bond strength between PEKK and composite was observed across all studies, influenced by material types, surface treatments, and test methods. Results: Notably, hydrofluoric acid etching with silane demonstrated the highest bond strength in two studies. Risk of bias varied among studies, with one exhibiting high risk, one showing moderate, and four showing low risk of bias. Surface treatments significantly enhance bond strength between veneering materials and PEKK, with sulfuric acid etching, sandblasting, and plasma treatment proving most effective. These findings provide valuable insights for selecting appropriate surface treatments in fabricating dental prostheses. Conclusions: The primary limitation of this review is the heterogeneity of the included studies in terms of methodology, adhesive systems, and surface treatments, which may introduce bias. Further studies in the field with more homogenous studies are required.