Temporomandibular Eklem Hastalarında Sabit Protetik Tedavide Materyal Seçimi

Abstract

Temporomandibular eklem bozuklukları (TME), çiğneme sistemini etkileyen, genellikle ağrı, disfonksiyon ve oklüzal stabilitenin bozulmasıyla sonuçlanan karmaşık bir hastalık grubunu temsil eder. TME tanısı almış hastalarda sabit protetik tedavi, değişen biyomekanik kuvvetler, parafonksiyonel alışkanlıklar ve eklem fonksiyonundaki bozulmalar nedeniyle benzersiz zorluklar içerir. Bu nedenle, kullanılan restoratif materyalin seçimi, protetik rehabilitasyonun uzun vadeli başarısında kritik bir rol oynamaktadır. Bu klasik derleme, sabit protetik tedavide güncel olarak kullanılan restoratif materyallerin genel bir değerlendirmesini sunmayı ve bunların TME bağlamındaki uygunluğunu tartışmayı amaçlamaktadır. Metal destekli porselenler, lityum disilikat seramikler, hibrit seramikler ve monolitik zirkonya gibi çeşitli materyal seçenekleri; mekanik özellikleri, stres dağılım davranışları ve fonksiyonel bozukluğu olan hastalardaki klinik performansları açısından ele alınmaktadır.Literatür, yüksek eğilme direnci, kırılma dayanımı ve minimal aşınma potansiyeline sahip materyallerin, özellikle monolitik zirkonyanın, artmış fonksiyonel yük gerektiren vakalarda önemli avantajlar sağlayabileceğini öne sürmektedir. Ayrıca, biyomekanik komplikasyonları en aza indirmek adına okluzal tasarım ve materyal kalınlığı dikkatle planlanmalıdır. Sonuç olarak, TME hastalarında restoratif materyal seçimi yapılırken hasta bazlı ve fonksiyon odaklı bir yaklaşım benimsenmelidir. Bu hasta grubunda tedavi sonuçlarını optimize etmek ve kanıta dayalı protokoller oluşturmak için ileri düzey klinik çalışmalara ihtiyaç duyulmaktadır.

Keywords

• Temporomandibular rahatsızlıklar
• bruksizm
• monolitik zirkonya
• tam seramik
• sabit protezler
• okluzal stabilite
• protetik rehabilitasyon

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