Kemal ÇOĞALAN, N. Esra BAĞDATLI, A. Ersan ERSOY

ALT ÇENE TAM DİŞSİZLİK OLGULARINDA ANTERİOR BÖLGEYE YERLEŞTİRİLEN İMPLANTLAR ÜZERİNE UYGULANAN FARKLI PROTEZ TASARIMLARININ İN VİTRO OLARAK KUVVET DAĞILIMI YÖNÜNDEN İNCELENMESİ

Amaç: Maksiler ve mandibuler posterior bölgelerdeki sınırlamalar nedeniyle ancak anterior bölgede uygulanabilen implantlardan destek alınarak yapılan sabit protezlere hassas tutucularla bağlanan posterior hareketli bölümlü protezlerin kombine protezler , implantlar ve kemikte oluşturdukları stresleri, sonlu elemanlar stres analiz yöntemi kullanılarak top başlı ve bar tutuculu overdenture tarzı protezlerle karşılaştırmalı olarak değerlendirmektir. Gereç ve Yöntem: Tam dişsiz mandibulada dört adet implant üzerine yapılan implant üstü sabit bir proteze hassas tutucularla bağlanan posterior hareketli bölümlü protez, top başlı ve bar ataçmanlı overdenture tarzı protez olmak üzere üç adet modeller üç boyutlu olarak tasarlanmış ve her bir modele 1. molar dişin merkezinden 100 N vertikal ve 100 N oblik kuvvet uygulanmıştır. Oluşan stresler, sonlu elemanlar stres analiz yöntemi ile incelenmiştir. Bulgular: İmplant üstü sabit bir proteze hassas tutucularla bağlanan posterior hareketli bölümlü protezde, top başlı ve bar tutuculu protezlere göre, implant ve peri-implant kemikte stresler daha yüksek, mukoza altındaki kortikal kemikte ise stresler daha düşük bulunmuştur. Aradaki farklar MPa cinsinden değerlendirildiğinde oldukça düşüktür. Sonuç: Anterior implant üstü sabit bir proteze hassas tutucularla bağlanan posterior hareketli bölümlü protez tasarımının, özellikle anterior bölgede kemik rezorpsiyonunun fazla olmadığı ve posterior bölgede ise bıçak sırtı kretlere sahip hastalarda top başlı ve bar tutuculu overdenture protezlere iyi bir alternatif tedavi seçeneği olarak kullanabileceği söylenebilir

Anahtar Kelimeler:

Dental implant, hassas tutuculu hareketli bölümlü protez, kombine protezler, overdenture, top başlı ataçman, bar ataçman, sonlu elemanlar stres analiz yöntemi

In vitro stress distribution evaluation of different prosthesis Designs supported by anterıorly located Implants in mandibular edentuolus cases

Objective: The aim of this study is to evaluate the stress transmitted to the peri-implant region and implants by an anterior fixed implant supported restoration with a precision partial denture posteriorly combined prothesis and to compare with bar and ball retained overdenture using finite element stress analysis. Materials and Methods: In our study we prepared three, three dimentional finite element models created on four implants, consisting of one distal extension mandibular removable partial denture connected to an anterior fixed implant supported prosthesis, one ball retained and one bar retained mandibular overdenture prothesis. 100 N vertical and 100 N oblique force were applied on the first mandibular molar teeth for each model. The stress were analysed by using the finite element stress analysis. Results: The results of our study show us that the amount of stress on peri-implant bone and implants were higher and the amount of stress on cortical bone under mucosa were lower for distal extension mandibular removable partial denture connected to an anterior fixed implant-supported prosthesis than bar and ball retained overdenture. The difference between stated prostheses were quite low when interpreted as MPa. Conclusion: A design of anterior fixed implant supported prosthesis combined with removable precision partial denture has a relatively lower degree of anterior bone resorption and may be a good alternative treatment choice instead of bar and ball retained overdenture for patients with posterior knife edge alveolar ridge

Keywords:

Dental implants, removable precision partial denture, combined prostheses, overdenture, ball attachment, bar attachment, finite element stress analysis,

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