Introduction: Maxillofacial patients utilize obturators, which may be colonized by microorganisms and function as a reservoir of infection. Biofilm formation differs according to the material type and processing technique, which has a critical impact on maxillofacial prosthetic materials' applications. Biomaterial‐associated infections cause serious complications, especially for immunocompromised maxillofacial patients.
Objectives: To assess Biofilm formation and microbial colonization of the normal oral and respiratory flora on the two commercially available forms of polyetheretherketone (modified PEEK); the CAD-CAM form and the Pressed PEEK in comparison to PMMA, and correlate them to average surface roughness.
Materials and Methods: Oral, nasal, and nasopharyngeal swabs were taken from a healthy volunteer.
Thirty-six circular discs were processed forming three groups: Group I: twelve (PEEK) discs were prepared with CAD-CAM technique, Group II: twelve PEEK discs with conventional Pressed technique, Group III: twelve heat polymerized polymethyl methacrylate (PMMA). All materials finishing and polishing was mimicking the clinical situation. Microbiological procedures were performed Average Surface roughness correlation to biofilm formation test was performed.
Results: There was no statistically significant positive correlation between average surface roughness and biofilm formation in all groups. CAD-CAM PEEK has lower biofilm formation than pressed PEEK, despite the rougher surface. Also, There was no statically significant difference between CAD-CAM PEEK or PMMA regarding biofilm formation.
Conclusions: Surface roughness is not the sole parameter for biofilm formation. Both PEEK processing techniques were positive for biofilm formation.



Biofilm, Digital, CAD-CAM, Surface roughness, PEEK, Maxillofacial prosthesis.
Running title: Bio-film formation on PEEK for obturator prosthesis.