Alveoler Kreti Korumaya Yönelik Güncel Bir Teknik: Soket Kalkanı Tekniği

Maksiller anterior estetik bölgede diş eksikliğinin dental implant destekli restorasyonlarla tedavisinde yeterli alveoler kemik hacminin ve uygun kemik mimarisinin olması gerekir. Dolayısıyla bu bölgede ideal fonksiyonel ve estetik rehabilitasyon için diş çekimi sonrası gelişen alveoler kemik rezorbsiyonunu engelleyecek ve kemik boyutlarını idame ettirebilecek birtakım teknikler (atravmatik çekim, soket ogmentasyonu, yönlendirilmiş kemik rejenerasyonu, soket seal tekniği ve immediat implantasyon gibi) önerilmektedir. Bu teknikler çekim sonrası alveoler kemiği rezorbsiyondan korumada belirgin etkiler gösterseler de alveoler soketin tamamen korunabildiği bir teknik henüz mevcut değildir. Diş çekimiyle birlikte periodontal ligament ve ilişkili vasküler desteğin kaybedilmesi rezorbsiyonun bir sebebi olarak görülür ve bu nedenle çekim sonrası tetiklenen fizyolojik kemik rezorbsiyonundan kaçınmak adına periodontal ligamentin bir kısmının soket içerisinde bırakılan kök fragmanı ile korunduğu Soket Kalkanı Tekniği tanımlanmıştır. Yapılan çalışmalara göre bu yeni tekniğin maksiller anterior estetik bölgede kemik dokusunu ve yumuşak dokuyu koruma amacıyla kullanılabileceği sonucuna varılmıştır. Ancak klinik pratikte geleneksel immediat implantasyon gibi kabul görmesi için hasta sayısının fazla olduğu, uzun dönem takipleri olan prospektif çalışmalara ihtiyaç vardır.

An Up-to-date Technique for Preserving Alveolar Socket: Socket Shield Technique

In maxillary anterior aesthetic region, adequate alveolar bone volume and appropriate bone architecture should be present for the treatment of tooth loss with dental implant-supported restoration. Therefore, a number of techniques such as atraumatic extraction, socket augmentation, guided bone regeneration, socket seal technique and immediate implantation are recommended in this region to prevent alveolar bone resorption and maintain bone dimensions for ideal functional and aesthetic rehabilitation. Although these techniques show significant effects in protecting the alveolar bone from resorption, a technique in which the alveolar socket can be fully protected is not yet available. Loss of periodontal ligament and associated vascular support is seen as a reason for resorption, and therefore, Socket Shield Technique has been defined in which some part of the periodontal ligament is protected by the root fragment left in the socket to avoid physiological bone resorption. According to the studies, it was concluded that this new technique can be used in the maxillary anterior aesthetic region to protect bone tissue and soft tissue. However, for its acceptance in clinical practice as conventional immediate implantation, prospective studies with large number of patients and long-term follow-ups are needed.

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