Dudak Damak Yarıklı Bir Hastanın Protetik Tedavisinin Yenilenmesi

Yıl 2024, Cilt: 34 Sayı: 2, 155 - 159, 15.04.2024

Tuğçe Çetin Umut Aslan Buket Evren Şebnem Begüm Türker

https://doi.org/10.17567/ataunidfd.998934

Öz

ÖZ
Dudak-damak yarıkları embriyolojik ve erken fetal dönemdeki gelişim bozukluklarının sonucu olarak gelişmektedir. Dudak damak yarıklı bireylerin tedavisinin temel amacı hastaların estetik, fonksiyon ve fonasyon problemlerini tedavi etmektir. Protetik tedavi; uzun süreli takip ve multidisipliner ekip çalışması gerektiren dudak damak yarıklı yetişkin bireylerin tedavisindeki son aşamadır. Bu vaka raporunun amacı; uyumunu kaybetmiş sabit ve hareketli protezi bulunan dudak damak yarıklı hastanın yenilenen protetik tedavisinin aşamaları hakkında bilgi vermektir. Çift taraflı dudak damak yarığı bulunan ve Marmara Üniversitesi Diş Hekimliği Fakültesi’inde 17 yıl önce tedavi edilmiş olan 36 yaşındaki bayan hasta mevcut protezlerinin yenilenmesi talebiyle Marmara Üniversitesi Protetik Diş Tedavisi Anabilim Dalına başvurdu. Sabit-hareketli (bar ataşman tutuculu) protez kullanan hastanın sabit protezleri desimante edilip destek dişlerin vitalitesi kontrol edildi ve maksiller sol kanin dişinde mobilite tespit edildi. Vitalite kaybı olan maksiller sol kanin ve ikinci küçük azı dişlerine endodontik tedavi yapıldı. Defekt bölgesinde bar ataşman altında kalan yumuşak dokuda proliferasyon olduğu tespit edildi. Prolifere doku diyot lazer ile eksize edildi. Daha önceden prepare edilmiş maksiller sağ/sol kanin ve küçük azı dişlerine minör preparasyon yapıldı. Sağ ve sol destek dişler çapraz ark stabilizayonu için dolder bar ile birbirine splitlendi. Sabit protetik tedaviler ve hassas tutuculu bölümlü protez aşamaları tamamlanarak hastanın protetik rehabilitasyonu sağlandı. Hareketli ve sabit protezin birlikte kullanılması ile çiğneme kuvvetleri dengeli bir şekilde destek dişlere iletildi. İdeal oklüzyon sağlandı. Hareketli protezin bukkal konturuyla kabul edilebilir estetik elde edildi ve hasta memnuniyeti sağlandı. Sonuç olarak bu vaka ile anterior bölgede kemik defekti bulunan çift dudak-damak yarıklı hastalarda hassas tutuculu hareketli protetik restorasyonların uygulanması ile estetik beklentilerin karşılanmasının, çiğneme ve konuşma fonksiyonlarının rehabilitasyonun başarıyla sonuçlandırılabileceği görüldü.
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Anahtar Kelimeler : Dudak damak yarığı, Hassas bağlantılı hareketli protez, Dolder bar
Prosthetic Retreatment of the Patient with Cleft Lip and Palate
ABSTRACT
Cleft lip and palate develops as a result of embryological and early fetal developmental disorders. The main purpose of the treatment of patients with cleft lip and palate is to treat aesthetic, function and phonation problems. Prosthetic treatment is the final stage in the treatment of adults with cleft lip and palate requiring long-term follow-up and multidisciplinary teamwork. The aim of this case report was to give information about the steps of renewed prosthetic treatment with a cleft lip and palate who has fixed and removable prosthesis that had insufficient retention and stability. A 36-year-old female patient with bilateral cleft lip and palate, treated 17 years ago at Marmara University was referred to the Marmara University Department of Prosthodontics for the complaint of her existing prostheses. The intraoral examination revealed a problem according to the retention and stability of her removable denture. The fixed prosthesis of the patient was desemented and the vitality of the supporting teeth was checked. Mobility was detected in the maxillary left canine tooth. Endodontic treatment was performed on the maxillary canine and second premolar teeth that lost vitality. Soft tissue proliferation under the bar attachment was detected in the defect area. Proliferated tissue was operated by using diode laser. Minor preparation was performed on previously prepared abutment maxillary right / left canine and premolars. The right and left abutment teeth are connected by a dolder bar to obtain bilateral stabilization. The prosthetic rehabilitation of the patient was completed by the fixed prosthetic treatment and the partial removable denture with precision attachment. The chewing forces is transmitted to the support teeth in a balanced manner to provide ideal occlusion with using the removable and fixed partial dentures together. In conclusion, with this case, it has seen an acceptable aesthetic was provided with the buccal section of the removable partial denture to achieve patient satisfaction. The function, fonation and aesthetics of patients with bilateral cleft lip and palate can be rehabilated by using removable partial denture with precision attachment.

Anahtar Kelimeler

Dudak damak yarığı, Hassas bağlantılı hareketli protez, Dolder ba

Dudak Damak Yarıklı Bir Hastanın Protetik Tedavisinin Yenilenmesi

Öz

ÖZ
Dudak-damak yarıkları embriyolojik ve erken fetal dönemdeki gelişim bozukluklarının sonucu olarak gelişmektedir. Dudak damak yarıklı bireylerin tedavisinin temel amacı hastaların estetik, fonksiyon ve fonasyon problemlerini tedavi etmektir. Protetik tedavi; uzun süreli takip ve multidisipliner ekip çalışması gerektiren dudak damak yarıklı yetişkin bireylerin tedavisindeki son aşamadır. Bu vaka raporunun amacı; uyumunu kaybetmiş sabit ve hareketli protezi bulunan dudak damak yarıklı hastanın yenilenen protetik tedavisinin aşamaları hakkında bilgi vermektir. Çift taraflı dudak damak yarığı bulunan ve Marmara Üniversitesi Diş Hekimliği Fakültesi’inde 17 yıl önce tedavi edilmiş olan 36 yaşındaki bayan hasta mevcut protezlerinin yenilenmesi talebiyle Marmara Üniversitesi Protetik Diş Tedavisi Anabilim Dalına başvurdu. Sabit-hareketli (bar ataşman tutuculu) protez kullanan hastanın sabit protezleri desimante edilip destek dişlerin vitalitesi kontrol edildi ve maksiller sol kanin dişinde mobilite tespit edildi. Vitalite kaybı olan maksiller sol kanin ve ikinci küçük azı dişlerine endodontik tedavi yapıldı. Defekt bölgesinde bar ataşman altında kalan yumuşak dokuda proliferasyon olduğu tespit edildi. Prolifere doku diyot lazer ile eksize edildi. Daha önceden prepare edilmiş maksiller sağ/sol kanin ve küçük azı dişlerine minör preparasyon yapıldı. Sağ ve sol destek dişler çapraz ark stabilizayonu için dolder bar ile birbirine splitlendi. Sabit protetik tedaviler ve hassas tutuculu bölümlü protez aşamaları tamamlanarak hastanın protetik rehabilitasyonu sağlandı. Hareketli ve sabit protezin birlikte kullanılması ile çiğneme kuvvetleri dengeli bir şekilde destek dişlere iletildi. İdeal oklüzyon sağlandı. Hareketli protezin bukkal konturuyla kabul edilebilir estetik elde edildi ve hasta memnuniyeti sağlandı. Sonuç olarak bu vaka ile anterior bölgede kemik defekti bulunan çift dudak-damak yarıklı hastalarda hassas tutuculu hareketli protetik restorasyonların uygulanması ile estetik beklentilerin karşılanmasının, çiğneme ve konuşma fonksiyonlarının rehabilitasyonun başarıyla sonuçlandırılabileceği görüldü.
Anahtar Kelimeler : Dudak damak yarığı, Hassas bağlantılı hareketli protez, Dolder bar
Prosthetic Retreatment of the Patient with Cleft Lip and Palate
ABSTRACT
Cleft lip and palate develops as a result of embryological and early fetal developmental disorders. The main purpose of the treatment of patients with cleft lip and palate is to treat aesthetic, function and phonation problems. Prosthetic treatment is the final stage in the treatment of adults with cleft lip and palate requiring long-term follow-up and multidisciplinary teamwork. The aim of this case report was to give information about the steps of renewed prosthetic treatment with a cleft lip and palate who has fixed and removable prosthesis that had insufficient retention and stability. A 36-year-old female patient with bilateral cleft lip and palate, treated 17 years ago at Marmara University was referred to the Marmara University Department of Prosthodontics for the complaint of her existing prostheses. The intraoral examination revealed a problem according to the retention and stability of her removable denture. The fixed prosthesis of the patient was desemented and the vitality of the supporting teeth was checked. Mobility was detected in the maxillary left canine tooth. Endodontic treatment was performed on the maxillary canine and second premolar teeth that lost vitality. Soft tissue proliferation under the bar attachment was detected in the defect area. Proliferated tissue was operated by using diode laser. Minor preparation was performed on previously prepared abutment maxillary right / left canine and premolars. The right and left abutment teeth are connected by a dolder bar to obtain bilateral stabilization. The prosthetic rehabilitation of the patient was completed by the fixed prosthetic treatment and the partial removable denture with precision attachment. The chewing forces is transmitted to the support teeth in a balanced manner to provide ideal occlusion with using the removable and fixed partial dentures together. In conclusion, with this case, it has seen an acceptable aesthetic was provided with the buccal section of the removable partial denture to achieve patient satisfaction. The function, fonation and aesthetics of patients with bilateral cleft lip and palate can be rehabilated by using removable partial denture with precision attachment.
Keywords: Cleft lip and palate, Removable prothesis with precision attachment, Dolder bar

Anahtar Kelimeler

Dudak damak yarığı, Hassas bağlantılı hareketli protez, Dolder bar

Kaynakça

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