Research Information System
International Journal of Adhesion and Adhesives, vol.145, 2026 (SCI-Expanded, Scopus)
Objective: 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.