Effectiveness of PEEK ultrasonic tips and cement types on residual cement around implant-supported restorations

Purpose The aim of this study was to assess the effectiveness of a PEEK (polyether-ether-ketone) ultrasonic tip in the cleaning around implant-supported restorations and to evaluate the effect of different cement types on the amount of residual cement at the restoration margins. Materials and methods A master model with an implant analogue placed in the upper left first premolar region was used to create 72 cast models and zirconia crowns were fabricated for each model. A total of 72 zirconia crowns were divided into two main groups based on the cleaning method applied after cementation. In the first group, residual cement was cleaned using only a dental explorer, while in the second group, cleaning was enhanced by using a PEEK ultrasonic tip following the initial use of a dental explorer. Each main group was further divided into three subgroups according to the type of cement used: polycarboxylate cement, glass ionomer cement and resin cement. After cementation and cleaning, the zirconia crowns were detached from the models, and cement residue was digitally photographed from the buccal, lingual, mesial and distal surfaces. The percentage of residual cement was then evaluated using Adobe Photoshop via pixel-based digital analysis. Data were analysed using the Shapiro-Wilk test, Robust ANOVA and Bonferroni method test for multiple comparisons. Results Statistical analyses revealed a significant difference between the cleaning methods regardless of cement type (p = 0.002). The results demonstrated that cleaning with a PEEK ultrasonic tip significantly reduced residual cement compared to using a dental explorer alone. Among the tested cements, resin cement left the least residual cement, while glass ionomer and polycarboxylate cements left significantly more residue (p <0.001). Conclusions The findings emphasise the clinical advantages of the PEEK ultrasonic tip cleaning method. Additionally, resin cement demonstrated the lowest amount of residual cement.