The document discusses the history and development of PEEK as a biomaterial for dental implants. PEEK was first commercialized in the 1980s for industrial applications due to its exceptional physical and chemical properties. Research into biomedical applications began in the 1990s, with PEEK approved for long-term implantation in 1997. Since then, PEEK usage has increased significantly in neurosurgery and orthopedics. The document outlines the advantages of PEEK implants over titanium, including being non-allergenic, radiolucent, and isoelastic to bone. Fundamental research studies on PEEK implants in animals and models show osseointegration and appropriate stress distribution. Clinical cases demonstrate successful long-term outcomes with PEEK

1. DUI Paris UPEC
28.- 30.5.2015
Dr Frank Spahn, Cannes, France
Introduction à l’implantologie isoélastique
Cours de Familiarisation avec PEEK

2. PEEK: DEVELOPPEMENT ET HISTOIRE
Commercialisation en domains industriels differents (aeronautique, automobile,
télécommunications)`vue ces propriétés physiques et chimiques exceptionnelles.
Depuis 1985 recherches en vue d’application en chirurgie orthopédique.
1992: Bioinertie and biocompatibilité approuvées par études fondamentales
1993: Premières applications comme implant dentaire en France
1997: Certification de PEEK-Optima pour implantation long-terme [Invibio], FDA, CE
1998: Disponibilité en neurochirurgie et chirurgie orthopédique
2000: Part du marché de PEEK en neurosurgery orthopédie < 2%
2008: Part du marché de PEEK en neurosurgery orthopédie > 50% [Invibio]
PEEK a été dévelloppé et breveté
pour ICI en 1982
Very low specific weight
Complete bridge 6-11gr
S
S0
100
1/1/1982
1/1/1986
1/1/1990
1/1/1994
1/1/1998
1/1/2002
1/1/2006
1/1/2010
1/1/2014
Série 1 Série 2 Série 3 Série 4

3. PEEK: DEVELLOPPEMENT ET HISTOIRE
Depuis 2004: Implants dentaires en PEEK composite avec phosphate ß-tricalcique [EVONIK]
2008: CE-marquage de ces implants en composite
2004-2010: Insertion de 5000 implants crestaux et basaux en PEEK composite
Depuis 2005: ca 1000 abutments et connecteurs PEEK-PERSO en fonction clinique
2008: CE-marquage des implants basaux en PEEK-OPTIMA, implants manufacturés par faconnage
2010/2011: CE-marquage des implants basaux et crestaux PERSO-B et PERSO-C manufacturés par injection
Publication d’une statistique de 3 ans concernant la technique PEEK-PERSO
9/2012: Insertions d’implants par membres IsoSS 2006-2012 : > 3000

4. PEEK: – Polyetheretherketon
Un thermoplastique polyaromatique semi-cristalline
Chemically inerte
Electrically inerte
Bad thermoconduction
Bioinerte
Stabilité performante in dimensions Poisson coeff 3
resistance mechanique élevée= comme os
ISO 10993
ISO 13485
ASTM F2026-07a
Long-term experiences in orthopedics
Fabricants:
Victrex/Invibio
Solvay
EVONIK
(-C6H4-O-C6H4-O-C6H4-C0-)n
Densité 1,3 – 1,8 g/cm³
Young modulus, elasticité
(corps non-linéaire) 4 – 11,5 Gpa
Flexural modulus
(corps ne changeantpas de diameter à la flexion 14-18 GPa
Dureté Rockwell M 99
saturation par fluide 0,4 – 0,5%
resistance Specifique 4 – 9x10^16 Ω/cm
Résistance surface 10^15 Ω/cm
Temperature fusion 334 – 348 ° C
(importance for environnemental reasons in fabrication)
Composite CFR augmente la conductivité
Multiples versions disponibles: couleur, barium, carbone or
glass reinforcé

5. Implant 17 in situ 1974 – 2001,
27 ans
Après incorporation d’une nouvelle
construction prothétique insuffisante, en
occlusion croisée pour le coté droit en 2001
expulsion de l’implant en-déans de 14 mois.
Le malheureux patient a du supporter après
28 ans une seconde intervention, nouvelle
construction prothétique en conditions
occlusales optimales; succès pour autres 7
ans jusqu’à son décès en 2008
L’Ere du titanium: Problématique dans le longterme
Died in 2008, 82 ans, masc
Les résultats en long-terme dependent des la maintenance de bonnes conditions occlusales

6. 5.01.1989
25.9.2006
Titanium-Era 1973 – 2005/8
Bons résultats, quelques problèmes persistent pendant des
longues années:
périimplantites i16 et fracture de la i46 en 1994
Problems with titanium implants are a reality, since 40 years

7. cC
46: implant fixé en greffe-onlay après 2 années en fonction
Perte de l’os greffé, infection avec poche profonde, periimplantite.

8. PEEK: Avantages en Implantologie Maxillo-faciale
• Pas de metallose
•Pas de polymetallose, pas d‘allergie
• pas d’échauffement en radiologie et radiothérapie
• pas d’artefact en imagerie radiologique
• pas de reaction en champs magnetiques
• inertie chimiquement, électrique et thermique et bio-inert
• résistance à l’hydrolyse
• pas de perte de matériel, de composants, pas de transfer
d’ions
•- Choc-absorption vers les 70 %
• pas d’ombre noir aux gencives et couronnes, teinte racines
•facile à manipuler, à corriger en direction, forme, élasticité
et affinité cellulaire

9. Overstress ou shielding effect si le matérial est trop
rigide

10. Problématiquedes matériaux rigides dans les
Volumes d‘os réduits et les qualités d‘os réduites, D4

11. Pertes multiples dans la phase de guérison osseus
- Allergie contre titanium?
- problèmes de défense immunitaire?
- just infection et/ou raisons méchaniques?

12. Constructions amovibles sur implants:
il faut de l‘os volumineux et de bonne qualité utilisant
un matériel implantaire rigide

13. PEEK: Avantages bioméchaniques
Réparation osseuse continu
en implantologie rigide
En implantologie isoélastique
Rémodelling suivant l‘activité
L’élasticité du PEEK est proche des valeurs de
l’os – un PEEK implant va reproduireles
mouvements interns de l’os
- Impossible de surcharger l‘os
- Impossiblité du PEEK de nuire les cellules osseuses
pendant les mouvements internes de l’os
- Pas d’effet de stress-shielding(protectionexagérée)
PEEK stimulates: Contact-Osteogenèse par
contact étroit sans dissociation de
l’interface, due aux straining equivalent des
deux media BONE and PEEK.

14. PEEK: Advantages in Maxillo-facial Implantology
•ISO-ELASTIQUE avec l’os et en plus
• metal free = de metallose ou polymetallose
•Pas de reactions allergiques
• pas de’échauffement à l’imagérie ou au traitement radiologique
• pas d’ artefacte en radiographie
• pas de réactions en champs magnétiques
• inertie électrique, thermique - et bio-inerte
• inerte pour réactions chimique résistant à l’ hydrolyse
• pas de perte de materiel, de composants, pas de transfert d’ions
• pas de liséré noir aux gencives ou rebords de couronnes, teinte blanche-ivoire
•Facile à tailler en salle de traitement,
•Correction facile de direction, de forme , élasticité, de l’affinite cellulaire

15. Pour charctériserla distribution des stress et compareravec des
implants rigides et charactériser la réponse de l‘os
PEEK: recherches fondamentales
Modèles d’éléments finis

16. PEEK: Modèle mathémathique de l’os,
des implants et couronnes
Os Corticale,
Os spongieux,
Os corticale
Contrainte sous 30 ; variation entre 10 et 80 MPa
20 MPa: déplacement/
déformation de l’os: 4 micron
Meningaud, Jean-Paul, Donsimoni, L’après titane, le PEEK ? After titanium, PEEK? Rev de Stom et Chir. Max-fac., Vol 113, 5, 11/2012

17. PEEK: Contraintes méchaniques en FEM
20 Mpa (162 N): déplacement/déformation de l’os: 5 micron
60 Mpa (389 N): déplacement/déformation de l’os: 5 micron

18. PEEK: Contraintes méchaniques en FEM
Unilatéral 20 MPa Unilatéral 30 MPa
Unilatéral 40 MPa Unilatéral 60 MPa

19. PEEK: Modèle d’éléments finis pour PERSO-B
Figure 8: Constraints obtained on the dental implant Ø7.
Maximum constraints: 245 MPa
Conclusion: The maximum constraint being lower than the
yield stress of the PEEK (337 MPa), one can deduce that the
implant resists the efforts which are applied to it.
Figure 3: Constraints obtained on the dental
implant Ø9.
Maximum constraints: 305 MPa
Conclusion: The maximum constraint being
lower than the yield stress of the PEEK (337 MPa),
one can deduce that the implant resists the efforts
which are applied to it.
Toute la litérature concernant PEEK: https://fr.sisomm.com/documentation/extraits-de-publication/

20. PEEK: Des différentes formes testées en
charges dynamiques
Mechanical Loading
Machine
Experimented by National Laboratories of Essay LNA, Trappes-France

21. PEEK - en comparaison avec d‘autres matériaux
• Enamel 84100
Material Young
(elasticity)
modulus MPa
Poisson
Ratio
Flexural
modulus
MPa
Cortical bone 17400 or less 0,3 17400
Medullar bone 1740 or more 0,3 200
PEEK OPTIMA LT1 6 BASO4 4000 or more 0,3 17000 or more
CFR-PEEK (carbone fibers) 18 000 0,39 = less
stability in
dimension
36000 or more
cpTi
Cr-Co
110000
218000
0,35
Hao, L., Harris, R., Bartolo, P., Bidanda, B., (eds.), Customised Implants for Bone Replacement and Growth,
Bio-Materials and Prototyping Applications in Medicine. Springer, 2008

22. PEEK: Recherche fondamentaux sur rats
Cortical bone = blanc, spongiosa: noir

23. PEEK: Recherche fondamentales à Munich
(Prof. Milz)
Os cortical = rose os spongieux = jaune-bleu
Induction de formation d‘os cortical sur un implant PEEK
en apposition directe

24. PEEK: Recherches fondamentales à l‘ Université de
Marseille (Prof. Chossegros)
Os corticale et trabecula=rose;os spongieux = jaune-bleu

25. PEEK: Système d’implantation
développé pour deux courants principaux dès 2006
Crestal implant PERSO-C 001 Basal implant PERSO-B 001

26. Adaptation en volume, hauteur,
direction du moignon,
forme, retentivité, elasticité
PEEK permet une
PERSONNALISATION
PERSO-C047
PERSO-C032
PERSO-B101L
Universal

27. Personnalisation
PEEK implants
PERSO-C
Contre-angle, 1:5,
160000-200000 rpm
Pièce à main droite, bleu,
pour la réduction du moignon
Par fraise-cloche OFR655-636
1:1, 40000rpm

28. Tailler PERSO-C032 and -C047

29. www.sisomm.com

30. 001 UNIVERSAL
Length of stub:
15mm

31. PROCEDURE GENERALE pour ATROPHIES prononcées du maxillaire

34. Publication des procédures sur www.sisomm.com

35. Publication des procédures chirurgicales, prothétiques et de maintenance sur www.sisomm.com

37. GENERAL PEEK PROCEDURE for SEVERE MAXILLA-ATROPHIES

38. Complete edentations in mild to extreme atrophies
in maxilla and mandibular – no graft, no sinuslift
These pictures shall train your eyes for detecting implants in regio 17, 14, 12, 22, 27, 37, 42, 47

39. Problems with titanium are
reality:
Radiological image in 16 is
not true:
The artefact exceeds
dimensions of implant
This implant fall just out of its alveola some
hours after the practitionner had confirmed
to the patient that radiologically the implant
was in best condition and she shall never loose
PAT N° 1

41. PAT N° 1

42. Osteoinductive effect of PEEK:
Almost no bone in 016 in 2009
Implantation during recovery
phase of former sinusitis
2012 , 3 years after single
tooth implantation i16
real bone structures
around the implant;
No more sinusitis!
PAT° 4

43. 6 years result

45. PEEK: Fondamental Studies in University of Marseille
(Prof. Chossegros)
Cortical bone and trabecula=rose;spongious bone = yellow-blue

46. Avoid xenografts and titanium in critical bone situations

47. PAT N° 6

48. Implantation 36 in november 2008;
here X-ray control in december 2012: Excellent osseintegration and mineralization
PAT N° 6

49. Clinical state i36 after 6 years: no complaints
PAT N° 6

50. PAT N° 6

51. Control-radiography in september 2014

53. With graft without graft without graft
Technic - crestal
Implants in titanium
Technic - basal
Implants in titanium
Technic - Mixed
Implants in PEEK
Since 1982 – author case descriptions non coherent:
• often (in general) in case of residuel bone height >3mm
• no informations about the volume residual bone
• Protocols non comparable
• no differenciation maxillary-mandibula
• no determination of treated regions
• publications on many systems of different implants
• no information about numbers of days of incapability to work
Since 1974 Since 2006
Published < 1000 cases in 30 years
Loss: of constructions : 15 % to 52 % in 7 months to 10 years
Published > 3000 cases
In 40 years
Loss: 1% to 8 %
After 3 to 20 years
Publié 450 cases
Loss: <3%
After 3 years
Authors:Johannson, B., et al., Widmark, et al.; Kramer, F.J., Schliephake, H., Wichmann, M.,
Umstadt,H.E., et al., Becker, W;, Tsirlis, A.T.,
Kawai, Y.,
Donsimoni, Navarro, Beckmann,
Kopp,Ihde, Scortecci, Spahn, Konst
antinovic, Mutter, Bocklage
Bagdasarov, Ghazaei,
Spahn, Feodorov,
Donsimoni
F.P. Spahn. , Reconstruction of Severe ly Resorbed Jaws with the New Metalfree Material PEEK and an adapted New Design of Implants avoiding increased Morbidity by Augmentation
Grafts.
Congrès SFSCMF 09/ 2011

54. PEEK: Multicortical support for avoiding grafts
Surgical Procedure in Basal PEEK-BASAL-Technic
2mm or more available bone:
No sinus-floorelevation
Less than 2mm of available bone:
Elevation of sinus-floor, fillingmaterial;
loading the sinus walls, bone grafts
never necessary

55. PAT N° 5

56. Attention to sinus-reaction post-
extractionem
PAT N° 5

57. Subtile Occlusal
Equilibration
required in
atrophies if
immediately loaded

58. 4 years
post-op
PAT N° 5

59. 6 years
Post-op
PAT N° 5

60. PEEK: COLD-PLASMA SURFACE TREATMENT
Create chairside free radicals on PEEK-surface after personalisation

61. THANK YOU
FOR YOUR ATTENTION

62. Video Nikos
• After: Athens after introduction 33

63. INDICATIONS for PEEK-PERSO-IMPLANTATIONS
• AFTER FAILURE of Titanium Implants
• Adaptability by shaping – a better fit in poor anatomical conditions
• SMALL BONE VOLUMINA avoiding augmentation
procedures with additional risks
• Bruxomania-patients
• SPONGIOUS BONE CONDITIONS – Bone Class D IV (Misch)
• ALLERGIC PATIENTS, Melyssa-test positiv
• No allergic reactions; No corrosion, no loss of ions, no interactions with other metalls

64. Shape the PERSO-B001 implant

66. Replaced titanium implants in 18, 16, 24, 26, 28 failed after 1 yea
PEEK-implants in 18 and 28 in function since 3 years

67. Harmony in occlusion
and correct
vertical dimension

70. Acceptable temporary bridges may load in
bilateral balanced and equilibrated occlusion
some carefully chosen implants

71. PEEK: PERSONNALISATION of Implants
CRESTAL and BASAL

74. 1- 2010
PEEK – SUPRACONSTRUCTIONS on
PEEK-IMPLANTS
shall be a good base for
excellent long-term results

75. 2012
- Primary stability
- Primary occlusion
- Compliance of patient in following the p

76. Temporarily we added som

77. Incorporation of
PEEK-Prosthesis in 12/2012

78. 3-2014

79. 5-2015

80. PEEK-PERSO-Procedure for the mandibule

82. Situation before treatment in the position of 16, 26 - pronounced bone deficit,
implant procedure with crestal (screw) implants is impossible without sinus-lift
Cas N° 3
Immediate loading in all cases
No loss of implant after 3 years
Patient contentness 100 %
Work incapacity 2-3 days post-op

83. Atrophie extrème en direction bucco-linguale crete de 2mm de large sur une hauteur de 15mm

85. In edentulous and partly edentulous mandibula , often implant procedures to fix a complete bridge are
impossible because of lack of bone substance, commonly then it will be called for nerve dislocation. But
the patient treatment acceptance is bad when all the disadvantages of the procedures are explained and
understood. Even newer solutions like using tilting implants in the manner of all-on-four or older ones like
displacing of the mandibular nerv or sandwich-plastics have showed a lot of disadvantages because of the
lack of comfort for the patient and are not indicated for 6mm height mandibulas . Authors do not describe
what solution they had for the progenic state of such patients.

86. INFRANERVAL 48
FREE of NERVE 6mm height
of mandibula in 43
N. Mentalis
2 typical insertions in case 3

92. OABU1
UNIVERSAL
PEEK-Abutments for PERSO-B- and PERSO-C-technics
OABU2
Standard
OAXE
SPECIAL
First function part
Second function part
May serve as
-cicatrization screw
-proloungerthread
to combine with
OAXE 2nd part
May serve as
-gingiva-former
-combine with thread
for a OABU2
Overbridge distances
between implant and
prosthetical
construction 12-28 mm
Parallelization 1-6°
For standard distance
5-12mm between
implant and
prosthetical
construction
Parallelization 1-6°
For parallelization of
more than 6° -20°
For screw-fixation of
prosthetics

93. La partie
de
l'image
avec l'ID
On Operation day: No use of Silicones for impressions
CHOICE
the
ABUTMENT

94. In all 4 cases the existing removable prostheses have been adapted
to the implants, reinforced by metal wires
and fixed with resin cement
Radiological interpretationwith PEEK
differs from classic metal implantations because ofabsence of artefacts
Translucidities are intensified in less mineralized(here after 5 months) or
because of less thick structures.

95. The patient could have been candidate for both-side sinus lifting and left-side maxillar lateral bone
augmentation procedure , prior to receive fixed prostheses for his upper and lower jaws. With our concept,
the new PEEK material and the new crestal and basal implant design, this patient benefited from a less
invasive procedure (one surgical procedure and no grafting), the best exploitation of the individual anatomical
situation, the incorporation of osteoconductive material PEEK and immediate extremely light and small
rehabilitation (prosthesis incorporated directly after surgery). 7 PERSO-B basal PEEK implants and 5 PERSO-C
have been installed in maxilla and mandibula in a 3 hours procedure. Post-operative situation for the position
16.

97. All patient have been in progenic situation but corrected prosthetically
The new PEEK material and PERSO implant design and procedure give to patients the benefit of
less intervention invasivity (1 surgical procedure and no grafting) than the known alternatives,
the best use of the individual anatomical situation without compromisses ,
the incorporation of osteoconductive material and
immediat extremely light and gracil rehabilitation (immediat full loading) .

98. PEEK PERSO-Concept it is a promissing technique for the
restoration of the severely atrophied mandibula avoiding
heavier surgery and other disadvantages for the patient.
Harmonic occlusal conditions have to be installed
as prealable condition for succes.

99. KEEP all parameters from former prosthetical constructions
for easier to optimize in the phase of temporary bridge

104. 5-2015

111. THANK YOU
FOR YOUR ATTENTION

112. Shaping abutment to fit in
existing bridge
Form, dimension and direction of
the abutment must be adapted to
install the crowns
Crowns fixed again
Fracture of the screwable abutment of
implant 21; PEEK-abutment on i21
Wrench to install abutment
Reparations on fractured stiff implants – titanium, circonium, medical steal

113. PEEK: Aesthetic Advantages

114. PEEK: Adaptable to all prostheses, bridges or
preexisting implants
fixeabutment on implant
To
rounden
de
square
end
Threader to
install a thread
Bellform bur….
Cut the abutmentat the length
needed
Install axe on the implant
PEEK abutments to iadaptand i
nstall on every type of implant

115. Non-fonctional thread in i36; creation of new thread i36, 0,40 with
threader OFR 620
And fixation of an abutment OAXE under existant crown

116. Our PEEK - abutment applications
during 2004 - 2010
Overall implant cases
1974 – 2010: >5100
with >22 400 implants
180 cases of reparation by PEEK
in 2004 to 2008 and 110 of these cases
were initially inserted before 1990
crestaux implants to repair - for fracture of the implant 5 - loss of function
of the initial - unsealings of the
superstructure screw pitch
75 52
18
- Basaux implants with - on the level of the screw pitch - on the part of
the barrel not broken external screwings
carrying the screw pitch
60 6
14
- overload of Ostéolyses - in case of implants crestales - in case of basals implants
around the implant material
221 41
180
- unsealings of - dento-implanto-portées - implanto-
portées
prosthetic structures
119 61
58
Spahn, F.P., Le métal comme connecteur
entre implant et prothétique remis en
question : Le PEEK une solution nouvelle,
durable et simple. 46th National Congress
of French Society of CMF-Surgery, SFCMFS
Paris, IX/2010

117. Left: Emerging in region 1-7
the metallic rest of an implant
Right: Threader in place to create
a new thread on the implant

118. Left: Abutment 1-7 in place;
modelling with a fraise OFR 1 to
adapt form, heights, volume to
the pre-existing bridge
Stump 1-7 ready to install crown
1-7 of pre-existing bridge

119. Bridge in place on abutment PEEK in region 1-7

120. PEEK Reparation of a non-functional implant thread
PEEK to save fractured or non-functional Titanium implants

122. Diagnose:
Atrophie du procès alvéolaire supérieur du maxillaire dans la région 14-25 surtout
horizontalement,
Dans la région molaire 15-18 et 25-28 surtout verticalement
Atrophie du procès alvéolaire de la mandibule prononcé , horizontale avec procès
alvéolaire en « lame de couteau »
Harmonic occlusal
conditions have to
be installed
as prealable
condition for
succes
even in temporary
bridges

128. 12months pos-operative: demineralization in regio 37
following overloading;
decision to add one implant in 35
Patients consentment to implant maxillary

129. 18 months post-operative,
recovery and remineralization around implants

130. months after implantation; confirmed osseointegration without signs of resorption

131. 54 months after implantation of the lower jaw, 36 months after implantation of upperjaw

133. Bilder Labille mit Keramik
Bilder von Scan post-op

134. Bilateral Equilibrated Balanced Occlusion
without Obstacles in lateral Deviation

137. The customers consent in using the technique in the first 18 months
- in two-step procedure, aware of the necessity of
loadable bone-reconstruction
- in early-loading to install bilaterally equilibrated balanced occlusion
only in patients with approuvedcompliance.
- The customers are equipped with machinery and instruments
permitting on its best to follow the proposed protocolls
- The customers make sign the patient a consentmentfor the
implantation where is fixed that the contractual follow-up will be respected
for 18 months with control-cone beams after 6 weeks, 6 months , 12 months
and 18 months;
that the patient has to stay in the treatment of the professional for 18 months
if ever a question should comes up.

138. PEEK: OUR EXPERIENCES
361 implants in 136 patients
Inserted in 3 European maxillo-facial surgery centers
By 3 practitionners (2006 – 2009)
Indications: to replace titanium implants which had to
be removed,
often, near to anatomical obstacles, reduced bone
Loss: 10 implants (early loss), < 1% after 3 to 6 years
IsoSS-running multicentrical study
8235 Implants,
inserted in multiple European maxillo-facial surgery centers
By more than 20 practitionners (2007-2014)
Avoiding bone grafts or sinus-lifts
Loss: 125 implants = ca 1,5 %

139. THANK YOU
FOR YOUR ATTENTION

143. Harmony in occlusion
and correct
vertical dimension

145. Autres traitements
proposés par différents auteurs
comportent des risques
intrinsiques et désavantageux
pour le patient:
-second site d‘operation
pour obtenir greffes autologues,
interventions répétés
-exclusion de charge immédiate
-nécessité d‘une prothèse
amovible temporaire
-Hospitalisation,
anesthésie générale
longue ou sédation prolongée et
répétée
-infection et
perte du matériel greffé

146. Avoid grafts, avoid sinuslift; work in two stages

147. PERSO-PEEK technic for to save limit constructions with metal implants

148. PAT° 3

154. Perfect bone healing after zystectomies and
extractions with simoultanous incorporation
of implants.
Loading of implants after 4 to 6 months

156. Six months post-operative; typicaldemineralization zone around PEEK implants but bone tissue stays in place. In PEEK
implantology we cannot find initial radioopacity becauseof the non-compressive implantation method without condensing
bone like with rigid titanium implants. There is less of radioopaque tissue for a while, but bone tissue!
After 12 months that radiotranslucency in images changes by more and more remineralization to strong radioopacity all
around the implant

157. 18 months later

161. PEEK: OUR EXPERIENCES
200 implants
Inserted in 3 European maxillo-facial surgery centers
By 3 practitionners (2006 – 2009)
Indications: to replace titanium implants which had to be removed and implantations near to
anatomicalobstacles, reduced bone
Loss: 2 implants (in the healing phase), < 1% after 3 to 6 years
30 implants
Inserted by 1 maxillo-facial surgeon (2008-2011)
in cases of
Extreme atrophies of upper or lower jaws avoiding bone grafts.
Loss: 2 implants
8235 Implants,
inserted in 6 European maxillo-facial surgery centers
By 12 practitionners (2007-2012)
Avoiding bone grafts or sinus-lifts
Loss: 125 implants = < 1,5 %

162. Internatio International Society for Promotion of Knowledge about Isoelastic Materials in IntraOSSeous Surgery
PEEK-PERSO-Technique delivers reproductible results and is
approuved for the treatment of cases
where Titanium implants have failed
and where more invasive adjuvant therapies
add risk to the pure implant risk.
The technique should be employed following the protocolls fixed
by IsoSS.

163. OPERATION-Course
MERIMNA-Institute
Athens
28.6.2014
Dr.Kostas Psomaderis, Athens
Dr Dr Frank Spahn, Cannes, France
Introduction in Isoelastic Implantology
The Science and Clinical Application of
PEEK-PERSO Implants in MAXILLO-FACIAL SURGERY

164. Dancing implants in bone substitutes

165. Problems in oral implantology:
Allergies
Infections
Immunitary systems’ deficiencies
beyond the suitable indications
Problems in maxillo-facial implantology
Infections
Patients’ Compliance
Mechanical Problems
Irrigation Problems
Allergies
Solution till in the
Nineties (till 1998):
Reimplant, Retry,
Change implant
system, Hope

166. Implantation site unsuitable for
oral implantology

167. Our request in the nineties:
A material that is
hypoallergen
isoelastic to bone
bioinert
chemically inert, corrosionfree
electrically inert
non-breakable
That material existed already
and was used by
neurosurgeons and in
orthopedic surgery:
PEEK – PolyEtherEtherKetone

168. Problems in oral implantology:
Allergies
Infections
Immunitary systems’ deficiencies
beyond the suitable indications
Problems in maxillo-facial implantology
Infections
Patients’ Compliance
Mechanical Problems
Irrigation Problems
Allergies
Solution up from
2006:
Change material
PEEK system, Hope

169. Replaced titanium implants in 18, 16, 24, 26, 28 failed after 1 yea
PEEK-implants in 18 and 28 in function since 3 years

171. Why to replace failed titanium implants by PEEK implants?
• Isoelasticity – less stress and less strain for bone cells, no shielding effect
Important for little bone volumina
• No corrosion, no loss of ions, no interactions with other metalls
• No allergic reactions
• Adaptability by shaping – a better fit in poor anatomical conditions
Important for little bone volumina
• One crestal implant type, one basal implant type personalised by surgeon

172. Extremly thin bone structuresand minimal bone volumina require adapted material physically similar

173. Replacing failed titanium implants up
from 2012 by PEEK
Change of paradigme: choice other material for implants
Isoelasticity – less stress and strain for bone cells, no shielding effect
Important for little bone volumina
No corrosion, no loss of ions
No allergic reactions
Change of paradigme: choice other material for superstructure
Adaptability by shaping – better fitting in the anatomicalconditions
Important for little bone volumina
Little specific weight; complete rehabilitationweighs 6 to 11 gr
Meningaud, JP, Donsimoni, JM, L’après titane, le PEEK ? After titanium, PEEK? Rev de Stom et Chir. Max-fac., Vol 113, 5, 11/2012

175. Special applications of the
PERSO-C001 Universal Implant
and the subtypes
- Pterygomaxillary Implant
- Zygoma Implant

176. PEEK- ZYGOMA-IMPLANT : Monobloc Procedure

181. 10 gram
Superstructures in PEEK are ultralight,
accomplishing all physical properties
required

183. PEEK

184. LE PEEK SOLUTIONS EXTRAORDINAIRES EN 1 JOUR BASAL
By Courtesy of
Dr. J.M.Donsimoni
UPEC, Paris, 2010

185. LE PEEK BASAL

186. LE PEEK

187. LE PEEK BASAL

192. THANK YOU
FOR YOUR ATTENTION