Polyetheretherketone (PEEK) as a Potential Material for the Repair of Maxillofacial Defect Compared with E-poly(tetrafluoroethylene) (e-PTFE) and Silicone

Siliconeand e-poly(tetrafluoroethylene) (e-PTFE) are the mostcommonly used artificial materials for repairing maxillofacial bonedefects caused by facial trauma and tumors. However, their use islimited by poor histocompatibility, unsatisfactory support, and highinfection rates. Polyetheretherketone (PEEK) has excellent mechanicalstrength and biocompatibility, but its application to the repair ofmaxillofacial bone defects lacks a theoretical basis. The microstructureand mechanical properties of e-PTFE, silicone, and PEEK were evaluatedby electron microscopy, BOSE machine, and Fourier transformed infraredspectroscopy. Mouse fibroblast L929 cells were incubated on the surfaceof the three materials to assess cytotoxicity and adhesion. The threematerials were implanted onto the left femoral surface of 90 malemice, and samples of the implants and surrounding soft tissues wereevaluated histologically at 1, 2, 4, 8, and 12 weeks post-surgery.PEEK had a much higher Young's modulus than either e-PTFE orsilicone (p < 0.05 each), and maintained highstiffness without degradation long after implantation. Both PEEK ande-PTFE facilitated L929 cell adhesion, with PEEK having lower cytotoxicitythan e-PTFE and silicone (p < 0.05 each). Allthree materials similarly hindered the motor function of mice 12 weeksafter implantation (p > 0.05 each). Connectivetissueingrowth was observed in PEEK and e-PTFE, whereas a fibrotic peri-prostheticcapsule was observed on the surface of silicone. The postoperativeinfection rate was significantly lower for both PEEK and siliconethan for e-PTFE (p < 0.05 each). PEEK shows excellentbiocompatibility and mechanical stability, suggesting that it canbe effective as a novel implant to repair maxillofacial bone defects.