Restoratif Diş Hekimliğinde Güncel Tedavi Yaklaşımlarının Değerlendirilmesi

Year 2024, Volume: 10 Issue: 1, 47 - 56, 17.04.2024

Gülben Çolak Muhittin Uğurlu

Abstract

Restoratif diş hekimliğinde güncel tedavi yöntemleri ve materyaller geliştirilmektedir. Ancak birçok tedavi yaklaşımı iyi kanıtlarla desteklenmeği için hekimlerin tedavi yöntemi tercihinde kararsızlığa neden olmaktadır. Bu tedavi yaklaşımlardan biri; rubber-dam izolasyonudur. Bu uygulamanın avantajları ve dezavantajları vardır. Çürük dentinin tamamen uzaklaştırılması diş yapısına zarar verdiği ve geri dönüşü olmayan sonuçlara neden olduğu için, günümüzde çürük dentinin selektif ya da aşamalı uzaklaştırılması savunulmaktadır. Dentinin örtülenmesi, mikrosızıntıyı ve post-operatif hassasiyeti azaltması nedeniyle uygulanması gereken bir yaklaşım olarak görülse de bağlanma için gerekli yüzey alanını ve restoratif materyalin kalınlığını azaltması sonucu restorasyonun biyomekanik özelliklerini olumsuz etkilemesi nedeniyle önerilmemektedir. Kanal tedavili dişlerin restorasyonunda, kalan diş yapısı miktarı direkt/indirekt restorasyon tercihinde önemli bir faktördür. Ayrıca, ferrule varlığı ve post kullanımı restorasyonun başarısını etkilemektedir. Post kullanımının olumsuz etkileri de vardır. Beyazlatma tedavileri ev tipi, ofis tipi ve ikisinin kombinasyonu olarak sınıflandırılmaktadır. Hekim hangi beyazlatma yöntemini uygulayacağına dişteki renklenmenin derecesi, kullanılan ajanın konsantrasyonu ve hasta-hekim uyumu gibi faktörlerin sonucunda karar vermelidir. Dentin hassasiyeti sıklıkla karşılaşılan ağrılı bir durumdur. Dentin hassasiyeti tedavilerinin amacı dış uyaranları ortadan kaldırarak, dentin tübüllerini tıkayarak ve sinirsel iletimi önleyerek ağrıyı azaltmaktır. Bu derlemenin amacı, bu tedavi yaklaşımlarını inceleyip, avantajlarını ve dezavantajlarını kanıta dayalı bir şekilde sunarak hekimlere bilgi vermektir.

Keywords

Çürük dentin, Dentin hassasiyeti, Diş beyazlatma, Kanal tedavili dişler, Rubber-dam

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