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This study aimed to evaluate a novel PEKK\/CaSiO<jats:sub>3<\/jats:sub>\/TeO<jats:sub>2<\/jats:sub> nanocomposite, comparing it to PEKK\/15\u2009wt.% CaSiO<jats:sub>3<\/jats:sub> and PEKK groups. The in\u00a0vitro study, involving 90 discs (<jats:italic>n<\/jats:italic>\u2009=\u200930), assessed the cytotoxicity of all groups after 24, 72, and 168\u2009h. The in\u00a0vivo animal study, using cylinder\u2010type implants (<jats:italic>n<\/jats:italic>\u2009=\u200930), evaluated osseointegration through biomechanical push\u2010out tests, descriptive histopathological examinations of decalcified sections stained with hematoxylin and eosin, and histomorphometric analysis of new bone formation area after 2\u2010 and 6\u2010week healing intervals. The cytocompatibility of PEKK\/15\u2009wt.% CaSiO<jats:sub>3<\/jats:sub>\/1\u2009wt.% TeO<jats:sub>2<\/jats:sub> composite confirmed its acceptance as a biomedical material. Additionally, in\u00a0vivo study results showed that the PEKK\/15\u2009wt.% CaSiO<jats:sub>3<\/jats:sub>\/1\u2009wt.% TeO<jats:sub>2<\/jats:sub> had the highest shear strength value and the highest new bone formation area compared to other experimental groups. The multimodal concept of adding CaSiO<jats:sub>3<\/jats:sub> micro fillers and TeO<jats:sub>2<\/jats:sub> nanofillers to PEKK produces a cytocompatible composite that enhances osseointegration and new bone formation in a rabbit's femur after 2\u2010 and 6\u2010week healing intervals.<\/jats:p>","DOI":"10.1002\/jbm.b.35535","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T06:16:20Z","timestamp":1737699380000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Biological, Biomechanical, and Histopathological Evaluation of Polyetherketoneketone Bioactive Composite as Implant Material"],"prefix":"10.1002","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9744-6049","authenticated-orcid":false,"given":"Manar E.","family":"Al\u2010Samaray","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, College of Dentistry Mustansiriyah University  Baghdad 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