Computer-aided design of polyetheretherketone for application to removable pediatric space maintainers

BACKGROUND: The premature loss of primary teeth is a common problem in pediatric dentistry, resulting in disruption of the arch integrity. Hence, space maintainers (SM) used for maintaining spaces are necessary. However, current methods of making removable space maintainers (RSM) have some limitations. METHODS: Digital models of dentition defects were obtained by using a scanning technique coupled with laser medical image reconstruction. The digital RSMs were designed using the 3Shape software. They were manufactured using two methods: polyetheretherketone (PEEK), and conventional methods (20 RSMs per group). For qualitative evaluation, the Likert five-point scale was used by 10 experts to obtain a score for 40 RSMs. The spaces between the tissue surfaces of the RSMs and the models were replaced using silicone, and the maximum and mean distances, as well as the standard deviation, were measured. A three-dimensional variation analysis was used to measure these spaces. The student’s t-test and Satterthwaite t-test were used to compare the differences in the spaces for the various materials. RESULTS: The PEEK RSMs were found to fit the models well. In the qualitative assessment, the mean experts’ scores for the PEEK and conventional groups were 1.80 ± 0.40 and 1.82 ± 0.40, and there was no significant difference between the two groups (p = 0.875). In the quantitative assessment, the mean spaces for the PEEK digital RSMs and the conventional RSMs were 44.32 ± 1.75 μm, and 137.36 ± 18.63 μm, respectively, and the differences were statistically significant (p < 0.001). In addition, there were significant differences in the maximum space and the standard deviation between the two groups. CONCLUSION: Digitally designed and integrated RSMs were found to be superior to those produced using the conventional method. 3D variation analysis results showed that the mean distances and standard deviations of the PEEK groups were significantly smaller than those of conventional group (p < 0.01). A PEEK-manufactured RSM produced using CAD/CAM would be extremely suitable for clinical applications.