Emine GÖNCÜ BAŞARAN, Hidayet ÇELİK, Ali İhsan ZENGİNGÜL, Hatice KOÇOĞLU

Sabit Protezlerde Altyapı Materyalleri Ve Sınıflandırmaları

Protetik diş hekimliğinde eksik dişlerin tedavisi için yapılan sabitprotezlerde çeşitli altyapılara sahip restorasyonlar kullanılmıştır.Bunlardan en çok tercih edilen metal altyapılı seramikrestorasyonlardır. Metal alt yapılı porselen sistemlerinin sahipolduğu avantajların dışında bazı dezavantajlar da mevcuttur. Sabitprotetik restorasyonlarda bu eksiklikleri gidermek için metaldesteksiz porselen sistemleri geliştirilmiştir. Metal-seramikrestorasyon sınıflaması standardize edilip, Amerikan DişhekimleriBirliği (ADA)’nın tüm soy metal alaşımlar için kabul ettiği sınıflamakabul edilirken tam seramik sistemler için birden fazla sınıflamamevcuttur.Konvansiyonel metal seramik sistemlerdeki dezavantajlar,araştırmacıları farklı restorasyon arayışlarına yöneltmiştir. Estetik,alerjik sebepler ve dişeti sağlığı dikkate alındığında, elektro kaplama sistemi ve tam seramik sistemler günümüzdekonvansiyonel sisteme iyi alternatif oluşturmaktadırlar. Ni-Cralaşımlar, yüksek gerilme direnci, yüksek sertlik, düşük maliyet vedüşük yoğunluk gibi avantajlarıyla en çok tercih edilen alaşımlardırama kontrol edilemeyen oksit tabakası oluşumu, alerjik reaksiyonve döküm zorluğu gibi dezavantajları da mevcuttur. Döküm altınalaşımlar ise döküm netliği, iyi fiziksel özellikler, biouyumluluk gibiavantajlarına karşın maliyetinin yüksek olması nedeniyle sık tercihedilmemektedirler. Elektro-kaplama sistemi, altın alaşımlarlakarşılaştırıldığında daha düşük maliyete sahip olması ve üretimkolaylığı avantajları vardır.Estetik ve biyouyumluluk gibi özelliklerinden dolayı zirkonya, sabitbölümlü protezlerde sıklıkla tercih edilmektedir. Mekanik ve fizikselözelliklerinin kemik ve dentine benzerliğinden dolayı Polieter EterKeton dişhekimliğinde birçok alanda kullanılmaktadır. Fiber ile güçlendirilmiş rezin tutuculu köprüler, ekonomik olarakdaha kapsamlı tedavileri karşılayamayan ve uzayan tedaviprotokollerini kaldıramayan hastalarda, hasta başı tedavilerinde,uzun vadeli geçici sabit parsiyel protezlerde, başarılı bir şekildeuygulanmaktadır. Yapılan protetik tedavilerde; altyapı seçimi içinuygun endikasyonlar ve kontrendikasyonlar göz önündebulundurularak kullanılacak materyal değerlendirilmelidir.

Infrastructure Materials and Classification in Fixed Prostheses

In prosthetic dentistry, restorations with various infrastructureshave been used in fixed dentures for the treatment of missingteeth. The most preferred of these are ceramic restorations withmetal infrastructure. Apart from the advantages of porcelainsystems with metal substructures, there are some disadvantages.Metal-backed porcelain systems have been developed toovercome these deficiencies in fixed prosthetic restorations. Whilethe metal-ceramic restoration classification is standardized andaccepted by the American Dental Association (ADA) for all noblemetal alloys, there is more than one classification for full ceramicsystems. The disadvantages in conventional metal-ceramic systems haveled researchers to seek different restorations. Consideringaesthetic, allergic causes and gum health, electro-coating systemand full ceramic systems are good alternatives to the conventionalsystem today. Ni-Cr alloys are the most preferred alloys with theiradvantages such as high tensile strength, high hardness, low costand low density, but they also have disadvantages such asuncontrollable oxide layer formation, allergic reaction and castingdifficulty. Casting gold alloys, on the other hand, are not preferreddue to their high cost, despite their advantages such as castingclarity, good physical properties and biocompatibility. The electro coating system has the advantages of having lower cost and easeof production compared to gold alloys. Due to its features such as aesthetics and biocompatibility,zirconia is frequently preferred in fixed section prostheses. Due tothe similarity of its mechanical and physical properties to boneand dentine, Polieter Ether Ketone is used in many fields indentistry. Fiber reinforced resin-retaining bridges are successfully used inpatients who cannot afford more comprehensive treatments andcannot remove prolonged treatment protocols, in bedsidetreatments, long-term temporary fixed partial dentures. Inprosthetic treatments; The material to be used should beevaluated considering the appropriate indications andcontraindications for the selection of the infrastructure

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