İMPLANT DESTEKLİ SABİT PROTEZLERDE OKLÜZYON PRENSİPLERİ

Kaybedilen dişlerin protetik rehabilitasyonu için dental implantların kullanımı, günümüz diş hekimliğinde oldukça sık kullanılan bir tedavi seçeneğidir. Ancak bu tedavi protokolü uygulanırken oklüzyon prensiplerine dikkat edilmediğinde komplikasyonlar ve hatta implant kayıpları görülebilir. Bunun önüne geçmek için dental implantların çevre dokular ile bağlantı şekli, fizyolojik olarak uyumu, kuvvet altında verdiği yanıtlar gibi faktörler göz önünde bulundurulmalıdır. Dental implantlar ve dişler arasındaki biyofizyolojik farklar, oklüzyon prensiplerinde de bir takım değişiklikler gerektirmektedir. Bu değişiklikleri bilmek, implantlara ve implant destekli restorasyonlara etki edebilecek olan oklüzal aşırı yükün engellenmesi için son derece önemlidir. Oklüzal aşırı yük, osseointegrasyon sonrası görülen implant kayıplarının en büyük etkenlerinden biri olarak gösterilmektedir. Bunun sebebi ise oklüzal aşırı yükün yüksek miktarda makaslama kuvvetine neden olmasıdır. İmplantlar sıkıştırma kuvvetlerine karşı son derece yüksek direnç gösterebilir. Ancak makaslama kuvvetleri implant ve çevre yapılara en fazla hasar veren kuvvet çeşididir. Oklüzyon tasarımında dikkat edilmesi gereken ise bu makaslama kuvvetlerini engelleyecek şekilde olmasıdır. Bu etkenlere örnek vermek gerekirse protez tasarımında oklüzal temas noktaları ve tüberkül eğimleri gibi faktörler kuvvetin iletimini etkilemektedir. Bu sebeple, protez tasarımına göre bir cerrahi plan yapılması tedavinin uzun dönem başarısı için büyük önem arz etmektedir. Bu derlemede, implant destekli sabit protetik restorasyonlarda oklüzal aşırı yüke neden olabilecek faktörlerden bu faktörlerin etki mekanizmasından ayrıca oklüzal aşırı yükün engellenmesi için gerekli olan oklüzyon prensiplerinden ve oluşabilecek komplikasyonlardan bahsedilmiştir.

Anahtar Kelimeler:

oklüzyon, sabit protezler, oklüzal aşırı yük, implant

Occlusion Principles for Implant Supported Fixed Dentures

The use of dental implants for the prosthetic rehabilitation of lost teeth is a very common treatment option in dentistry. However complications and even implant losses may occur when the principles of occlusion are not observed while applying this treatment protocol. To prevent this, factors such as the connection of dental implants with the surrounding tissues, their physiological compatibility and their responses under force should be taken into consideration. Biophysiological differences between dental implants and teeth also require some changes in the principles of occlusion. Knowing these changes helps implants and implant-supported restorations it is extremely important to prevent occlusal overload, which may affect. Occlusal overload is shown as one of the biggest factors of implant losses after osseointegration. Because, the occlusal overload causes a high shear force. Implants can exhibit extremely high resistance to compression forces. However, shear forces are the most damaging type of implant and surrounding structures. What needs to be considered in the design of occlusion is that this will prevent shear forces. To give an example of these factors, factors such as occlusal contact points and inclination of cusps in the prosthesis design affect the transmission of the force. Therefore, making a surgical plan according to the prosthetic design is of great importance for the long-term success of the treatment. In this review, the factors that can cause occlusal overload in implant-supported fixed prosthetic restorations, the mechanism of action of these factors, and the occlusion principles and complications that may occur to prevent occlusal overload are mentioned.

Keywords:

occlusion, fixed prostheses, occlusal overload, implant,

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