Effect of surface treatments on the bond strength between high-performance polymers (PEEK/PEKK) and acrylic resin materials: A systematic review and meta-analysis

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dc.contributor.authorKhosroabadi, Mahla
dc.contributor.authorKhosroabadi, Ebrahim
dc.date.accessioned2026-07-01T11:40:02Z
dc.date.available2026-07-01T11:40:02Z
dc.date.issued2026
dc.departmentDüzce Üniversitesi
dc.description.abstractObjective: To quantify the effect of surface-treatment protocols on the bond strength between high-performance polymers-polyetheretherketone (PEEK) and polyetherketoneketone (PEKK)-and acrylic resin materials used in prosthodontics. The review addressed the PICO question: Among in vitro studies on PEEK/PEKK specimens, which mechanical, chemical, or laser surface treatments improve adhesion to acrylic resins compared with untreated surfaces? Methods: Following PRISMA 2020 guidelines (PROSPERO: CRD420251050752), electronic searches of PubMed, Scopus, Web of Science, and Embase were conducted up to June 2024. In vitro studies evaluating bond strength between treated and untreated PEEK/PEKK specimens and acrylic resins were included. Methodological quality was assessed using the Faggion Jr. (2012) tool. Random-effects meta-analysis with subgroup and meta-regression analyses explored sources of heterogeneity. Results: Ten studies involving 1208 specimens met the inclusion criteria. Laser irradiation, sulfuric acid etching, and tribochemical silica coating with silane primer significantly increased bond strength compared with untreated controls (p < 0.001). Although heterogeneity was high (I2 = 92.8 %), resin type and aging protocol explained part of the variance, whereas differences in testing mode contributed most to residual variability. Most studies showed moderate risk of bias, mainly due to lack of randomization and blinding. Conclusions: Surface modification markedly enhances the adhesion of PEEK and PEKK to acrylic resins. Combined mechanical-chemical or laser-based treatments provide the most consistent improvements. Standardized testing protocols and higher methodological rigor are required to validate these findings. Clinical significance: Optimized surface-conditioning protocols are essential for durable, predictable bonding between high-performance polymers and acrylic resins, enabling broader clinical use of PEEK- and PEKK-based prosthetic frameworks.
dc.identifier.doi10.1016/j.ijadhadh.2025.104206
dc.identifier.issn0143-7496
dc.identifier.issn1879-0127
dc.identifier.orcid0009-0009-3484-7713
dc.identifier.scopus2-s2.0-105022161166
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1016/j.ijadhadh.2025.104206
dc.identifier.urihttps://hdl.handle.net/20.500.12684/23601
dc.identifier.volume145
dc.identifier.wosWOS:001626989800001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.language.isoen
dc.publisherElsevier Sci Ltd
dc.relation.ispartofInternational Journal of Adhesion and Adhesives
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20260623
dc.subjectPeek
dc.subjectPekk
dc.subjectSurface Treatment
dc.subjectBond Strength
dc.subjectAcrylic Resin
dc.subjectProsthodontics
dc.subjectTribochemical Silica Coating
dc.subjectLaser Etching
dc.subjectSystematic Review
dc.subjectMeta-Analysis
dc.titleEffect of surface treatments on the bond strength between high-performance polymers (PEEK/PEKK) and acrylic resin materials: A systematic review and meta-analysis
dc.typeArticle

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