ANTERİOR BÖLGEDEKİ İMPLANT ÜSTÜ PROTEZLERDE YUMUŞAK DOKU ESTETİĞİ: 3 OLGU SUNUMU

Amaç: Periodontal sebeplerle sağ üst lateral dişini kaybeden 45 yaşındaki bayan hasta ile konjenital lateral diş eksikliği bulunan 19 yaşındaki erkek ve bayan 2 hastanın ortodontik tedavi sonrası implant üstü sabit protezler ile gerçekleştirilen estetik rehabilitasyonlarının sunulması amaçlanmıştır. Gereç ve Yöntemler: Sağ üst lateral eksikliği bulunan 45 ve 19 yaşındaki bayan hastalara implant uygulanmasının ardından ölçüleri alınarak vidalı kompozit kuronlar elde edilmiş ve immediat olarak yüklenmiştir. 4 aylık iyileşme sürecinin ardından Hind’s tekniği ile daimi ölçüler elde edilmiş ve titanyum altyapılı zirkonyum hibrit abutment ve zirkonyum altyapılı porselen kuronlar ile tedavileri gerçekleştirilmiştir. Konjenital lateral eksikliği bulunan 19 yaşındaki erkek hastada ise immediat yükleme yapılamamış ve 3 aylık iyileşme sürecinin ardından uygulanan zirkonyum altyapılı porselen kuronlar ile estetik rehabilitasyonu tamamlanmıştır. Sonuç: İmmediat implantasyon ve geçici restorasyon kullanımı sayesinde; anterior bölgede diş eksikliği bulunan 3 hastada uygun çıkış profili elde edilerek doğal yumuşak doku estetiği sağlanmıştır. Erkek hastamızın 1 yıllık ve bayan hastalarımızın 3 aylık kontrollerinde herhangi bir komplikasyona rastlanmamıştır. Anahtar kelimeler: yumuşak doku estetiği, hibrit abutment, implant, immediat yükleme, geçici kron   SOFT TISSUE ESTHETICS ON IMPLANT-SUPPORTED PROSTHESIS IN ANTERIOR REGION: 3 CASE REPORTS ABSTRACT Objective: To report cases of esthetic rehabilitations of a 45-year old female patient with loss of right maxillary lateral incisor due to periodontal disease and 19-year old male and female patients with congenitally missing maxillary lateral, carried out with implant-supported prosthesis after the orthodontic treatment. Material and Methods: After implant applications of female patients with missing maxillary lateral, the impressions were taken and screw-retained composite crowns were loaded immediatly. After 4 months of healing period, permanent impressions were taken with Hind's technique and the treatment was carried out with titanium-based zirconium hybrid abutment and zirconium crowns. Immediat loading could not be applied to 19 year-old male patient with congenitally missing lateral incisors, so the esthetic rehabilitation was carried out with zirconium crowns after 3 months of healing period. Conclusion: Due to the immediate implantation and the use of the provisional restorations; natural soft tissue esthetics were obtained by the appropriate emergence profile. In 1 year follow-up of male patient and 3-month follow-up of female patients, no complications were observed. Keywords: soft tissue esthetic, hybrid abutment, implant, immediate loading, provisional crown

___

  • 1) Julia-Gabriela Wittneben, Urs Brägger, Daniel Buser, Tim Joda. Volumetric calculation of supraimplant submergence profile after soft tissue conditioning with a provisional restoration. The International Journal of Periodontics & Restorative Dentistry; Volume 36, Number 6, 2016: 785-790
  • 2) Merve Çakır, İnci Rana Karaca. İmplant Uygulamaları İçin Kret Koruma Tebikleri. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi; Cilt:25, Sayı: 1, Yıl: 2015, Sayfa: 107-118)
  • 3) Julia-Gabriela Wittneben, Daniel Buser, Urs C. Belser, Urs Brägger. Peri-implant soft tissue conditioning with provisional restorations in the esthetic zone: the dynamic compression technique. The International Journal of Periodontics & Restorative Dentistry; Volume 33, Number 4, 2013: 447-455
  • 4) Zinde Güder, Önjen Tak, Bahadır Kan, Fatih Mehmet Coşkunses. Travma sonucu oluşan anterior tek diş eksikliklerinin implant destekli sabit restorasyonlar ile tedavisi: 2 olgu sunumu. Selcuk Dental Journal, 2015; 3: 136-143
  • 5) MB Lewis, I Klineberg. Prosthodontic considerations designed to optimize outcomes for single-tooth implants. A review of the literature. Australian Dental Journal 2011; 56: 181–192
  • 6) Paul S. Petrungaro. Creation and Preservation of Natural Soft Tissue Emergence Profile Around Dental Implants in the Esthetic Zone. Journal of Cosmetic Dentistry; Volume 24, Number 4, 2009: 66-80
  • 7) David Furze, Sonia Alam, Julia-Gabriela Wittneben. Esthetic outcome of implant supported crowns with and without peri-implant conditioning using provisional fixed prosthesis: a randomized controlled clinical trial. Clinical Implant Dentistry and Related Research, Volume 18, Number 6, 2016: 1153-1162
  • 8) Drs. Andrea Parpaiola, Luca Sbricoli, Riccardo Guazzo, Eriberto Bressan & Diego Lops. Managing the peri-implant mucosa: a clinically reliable method for optimizing soft-tissue contours and the emergence profile. Journal of Esthetic and Restorative Dentistry. 2013 Oct;25(5):317-23
  • 9) Himanshu Arora, Nabil Khzam, David Roberts, William L Bruce, Saso Ivanovski. Immediate implant placement and restoration in the anterior maxilla: tissue dimensional changes after 2-5 year follow up. Clin Implant Dent Relat Res. 2017;19:694–702.
  • 10) Jung Nam, Prasit Aranyarachkul. Achieving the optimal peri-implant soft tissue profile by the selective pressure method via provisional restorations in the esthetic zone. (Journal of Esthetic and Restorative Dentistry. 2015 May-Jun;27(3):136-44
  • 11) Po-Sung Fu, Yi-Min Wu, Ching-Fang Tsai, Ta-Ko Huang, Wen-Cheng Chen, Chun-Cheng Hung. Immediate provisional restoration of a single-tooth implant in the esthetic zone: A case report. Kaohsiung Journal of Medical Sciences (2011) 27, 80-84
  • 12) Kokich VO Jr, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. Journal of Esthetic Dentistry 1999;11: 311-324.