occlusion in implant prostheses

Öz

There are many biological and physiological differences between natural teeth and implants. So, it isn’t appropriate to apply the occlusion rules of natural teeth directly to implant-supported restorations. One of the most important reasons for this is the absence of natural periodontal tissues around the tooth around the implant. This situation deprives the implant of the shock absorption ability of the natural tooth and applying excessive force to the implant may cause irreversible problems. If the damage to the surrounding tissue of the implant is detected early, recycling may be possible or the damage can be stopped, but if the problem is advanced, implant may be lost. Affected soft tissues around the implant can cause periimplant gingivitis , and if not treated periimplantitis can occur. Finally, implant loss may occur due to bone loss over time. In such patients, prosthetic examination should be performed besides periodontal treatment, and occlusal adjustments should be made if destruction of periodontal tissues due to occlusion is suspected. Meanwhile, some damage may occur on the implant spacers and implant. Fractures, cracks and decimentation may occur in implant-supported prostheses. To minimize these occlusal forces on the implant and bring it to a tolerable level, some modifications should be made in the occlusion and an occlusion that will protect the health of the implant should be obtained. We aimed to reveal the researches on these modifications and to ensure that sufficient knowledge is reached to provide a near ideal implant occlusion when making an implant-supported prosthesis.

Anahtar Kelimeler

• Dental occlusion
• dental prosthesis implant-supported
• periodontal ligament

İmplant Üstü Protezlerde Oklüzyon

Öz

Doğal dişler ve implantlar arasında biyolojik ve fizyolojik olarak birçok farklılık vardır. Bu sebeple doğal dişlerdeki oklüzyon kurallarının implant destekli restorasyonlarda direkt uygulanması uygun bulunmamaktadır. Bunun en önemli sebeplerinden birisi implant çevresinde, diş çevresinde bulunan doğal periodontal dokuların bulunmamasıdır. Bu durum implantı doğal dişte bulunan şok absorpsiyon yeteneğinden yoksun kılar ve implanta fazla kuvvet geldiği durumlarda geri dönülmez problemler oluşturabilir. İmplantın çevre dokusunda meydana gelen hasar erken tespit edildiği takdirde geri dönüşümü mümkün olabilir veya oluşan hasar durdurulabilir ancak problem ileri düzeydeyse bu durum implantın kaybına sebep olabilir. İmplant çevresindeki yumuşak dokunun etkilenmesiyle periimplant gingivitis, tedavi edilmediği durumlarda periimplantitis görülebilir. Sonuç olarak zaman içerisinde oluşan kemik kaybından kaynaklı implant kaybı oluşabilir. Bu tip hastalarda periodontal tedaviye ek olarak protetik muayene de yapılmalı ve periodontal dokularda oluşan harabiyetin oklüzyon kaynaklı olduğundan şüpheleniliyorsa oklüzal düzenlemeler de mutlaka yapılmalıdır. Aynı zamanda implant ara parçaları ve implant üzerinde de birtakım hasarlar oluşabilir. İmplant üstü protezlerde de kırılmalar, çatlamalar ve desimantasyon meydana gelebilmektedir. İmplanta gelen bu oklüzal kuvvetleri minimalize etmek ve tolere edilebilecek düzeye getirmek için oklüzyonda birtakım modifikasyonlara gidilmeli ve implant sağlığını koruyacak bir oklüzyon elde edilmelidir. Bu derlemedeki amacımız bu modifikasyonlarla ilgili araştırmaları ortaya koymak ve bir implant üstü protez yaparken ideale yakın bir implant oklüzyonu sağlayabilmek için yeterli bilgi düzeyine ulaşılmasını sağlamaktır.

Anahtar Kelimeler

• Diş oklüzyonu
• İmplant destekli diş protezi
• Periodontal bağ

Kaynakça

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