Assessing the role of PEKK implant material on cytotoxicity, inflammatory response, and molecular interactions with pro-inflammatory cytokines: An in-vitro and in-silico study.

Introduction: and aim: Due to its excellent mechanical strength and biocompatibility, Polyetherketoneketone (PEKK) is emerging as a potential substitute for titanium in dental implant applications. The aim of the study was to evaluate its cytotoxicity, pro-inflammatory responses, and molecular interactions to assess its potential in implant applications.

Methods: This study evaluated the cytotoxicity, pro-inflammatory cytokine responses, and molecular interactions of PEKK compared to titanium. Disc-shaped samples (10 mm × 2 mm) were fabricated for each material following ISO standards. Human periodontal fibroblast cells were cultured and treated with the samples for cytotoxicity assessment using the MTT assay, while pro-inflammatory cytokine gene expression (IL-1β, TNF-α) was analyzed via real-time PCR. Molecular docking was conducted using AutoDock to investigate PEKK's binding interactions with cytokines, and data was analyzed with one-way ANOVA and post hoc test (P < 0.05).

Results: PEKK showed comparable cytocompatibility to titanium, yielding similar outcomes in cell viability (P > 0.05) or pro-inflammatory cytokine expression (P > 0.05). Molecular docking revealed strong interactions with IL-1β (-8.9 kcal/mol) and TNF-α (-7.3 kcal/mol).

Conclusion: This study demonstrates that PEKK exhibits comparable cytocompatibility and pro-inflammatory responses to titanium, with a potential to modulate inflammatory pathways. Further in vivo studies are needed to confirm its clinical viability as an implant material.

Clinical relevance: This study gives the clue of PEKK as an aesthetic implant biomaterial and it can be useful as an alternative to Titanium dental implant.