BioHPP in prosthetic dentistry: a narrative review of mechanical, biological, and clinical properties

Biocompatible high-performance polymer (BioHPP), a high-performance polymer derived from polyetheretherketone (PEEK) and reinforced with ceramic fillers, has emerged as a promising alternative to conventional metal and ceramic framework materials in prosthetic dentistry. With an elastic modulus (~4 GPa) comparable to that of cortical bone, BioHPP promotes physiological stress distribution and reduces stress shielding, thereby supporting peri-implant bone preservation. Its excellent chemical inertness and low bacterial affinity minimize mucosal inflammation and reduce the risk of peri-implant disease. However, the material's low surface energy and hydrophobicity pose challenges to long-term adhesive stability, necessitating specific surface modification techniques and specialized adhesive systems. Clinically, BioHPP has been successfully applied in single crowns, fixed partial dentures, full-arch hybrid prostheses (e.g. All-on-Four), bar-retained overdentures, maxillofacial frameworks, customized abutments, and provisional restorations. Despite its favorable biomechanical and biological profile, limitations such as inherent opacity, restricted fracture toughness, and the scarcity of long-term clinical data highlight the need for further interdisciplinary research and material innovation. This narrative review comprehensively evaluates the mechanical, biological, and adhesive characteristics of BioHPP, compares its performance with traditional framework materials, and discusses its clinical applications and future perspectives in prosthetic rehabilitation.