İmplant Destekli Protetik Restorasyonlarda Kullanılan Üst Yapı Materyalleri ve Seçim Kriterleri

Öz

Protetik diş hekimliğinde tedavinin hedefi; eksik dişlerin, dişlerdeki madde kayıplarının ve çevre dokularda meydana gelmiş olan defektlerin giderilmesi, fonksiyonel ve estetik açıdan hastanın rehabilitasyonunun protetik restorasyonlar ile sağlanmasıdır. Eksik dişlerin ve bu dişleri destekleyen yapıların implant destekli protezlerle değiştirilmesi, kısmi ve tam dişsiz bireylerin yaşam kalitesini artırmaktadır. Dental implant restorasyonu, eksik dişler için kanıtlanmış restoratif bir tedavi yöntemidir. Tam veya kısmi dişsizliğe sahip hastalar için güvenli, etkili, kalıcı, uzun vadeli işlevsel ve estetik bir çözümün yanı sıra öngörülebilir sonuçlar sunmaktadır. Ancak, dental implantların ve üzerine uygulanmış olan restorasyonların başarısı ve uzun ömürlülüğü birçok faktöre bağlıdır. Günümüzde implant tedavisinin başarılı olabilmesi, sadece implantın osteointegrasyonuna ve hayatta kalmasına bağlı değildir. Bununla birlikte yapılmış olan implant destekli protezin uzun süre stabilitesi, estetik ve fonksiyonel olarak iyi sonuç vermesi ve temizlenebilir olmasına bağlıdır. İmplant destekli protezler, hem yeni protez malzemelerinin üretilmesi hem de öngörülebilirlik, doğruluk ve tekrarlanabilirlik sunan bilgisayarlı üretim teknolojilerinin ortaya çıkmasının ardından son yıllarda önemli derecede gelişmiştir. Öte yandan, implant destekli protezlerin elde edilmesinde günümüze kadar kullanılmış olan geleneksel materyallerin kalitesi ve klinik performansları da kabul edilmiş bir gerçektir. Bu derlemenin amacı; farklı implant destekli materyaller hakkında bilgi vermek ve implant destekli materyalleri karşılaştırarak estetik ve fonksiyonel açıdan en ideal materyalin seçilmesini sağlamaktır.

Anahtar Kelimeler

• : Dental materyal
• diş implantı
• implant destekli diş protezi

Superstructure Materials Used in Implant-Supported Prosthetic Restorations and Selection Criteria

Öz

The aim of treatment in prosthodontics is to address missing teeth, substance losses in teeth, and defects in surrounding tissues, achieving functional and aesthetic rehabilitation for the patient through prosthetic restorations. Replacing missing teeth and their supporting structures with implant-supported prostheses enhances the quality of life for both partially and fully edentulous individuals. Dental implant restoration is a proven restorative treatment method for missing teeth. It offers a safe, effective, permanent, long-term functional, and an aesthetic solution with predictable results for patients with complete or partial edentulism. However, the success and longevity of dental implants and the restorations placed on them depend on many factors. Nowadays, the success of implant treatment relies not only on osseointegration and implant survival but also on the long-term stability of the implant-supported prosthesis, achieving aesthetic and functional excellence, and ensuring ease of cleanliness. In recent years, implant-supported prostheses have significantly improved with the production of new prosthetic materials and the emergence of computer-aided manufacturing technologies that offer predictability, accuracy, and reproducibility. On the other hand, the quality and clinical performance of traditional materials used to date in the fabrication of implant-supported prostheses are also acknowledged facts. The purpose of this review is to provide information about different implant superstructure materials and compare implant superstructure materials to select the most ideal material in terms of aesthetics and functionality.

Anahtar Kelimeler

• Dental material
• dental implant
• implant-supported dental prosthesis

Kaynakça

1. Wittneben JG, Joda T, Weber HP, Brägger U. Screw retained vs. cement retained implant-supported fixed dental prosthesis. Periodontology 2000. 2017;73(1):141-151. doi:10.1111/prd.12168
2. Hamed MT, Mously HA, Alamoudi SK, Hashem ABH, Naguib GH. A systematic review of screw versus cement retained fixed implant supported reconstructions. Clin Cosmet Investig Dent. 2020;12:9-16. doi:10.2147/CCIDE.S231070
3. Meneghetti PC, Pittas do Canto PE, Spohr AM, Burnett LH Jr. Fracture Load of Monolithic CAD/CAM Ceramic Crowns Placed on Different Implant Abutments. Int J Oral Maxillofac Implants. 2022;37(6):1217-1222. doi:10.11607/jomi.8855
4. Al Thobity AM. Titanium base abutments in implant prosthodontics: a literature review. Eur J Dent. 2022;16(1):49 55. doi:10.1055/s 0041 1735423
5. Moilanen P, Hjerppe J, Lassila LVJ, Närhi TO. Fracture strength and precision of fit of implant retained monolithic zirconia crowns. J Oral Implantol. 2018;44(5):330–334. doi:10.1563/aaid-joi-D-17-00249
6. Janev E, Redzep E, Janeva N, Mindova S. Multi unit abutments recommended in prosthetic and surgical implantology treatment (case report). J Morphol Sci. 2020;3(1):65–72.
7. Mizrahi B. Temporary restorations: the key to success. Br Dent J. 2019;226(10):761–768. doi:10.1038/s41415 019 0360 1
8. Slokar L, Pranjić J, Carek A. Metallic materials for use in dentistry. Holist Approach Environ. 2017;7(1):39–58.

9. Sulaiman TA. Materials in digital dentistry — A review. J Esthet Restor Dent. 2020;32(2):171–181. doi:10.1111/jerd.12566
10. Eşgünoğlu Çelik G, Balkaya MC. Metal Manufacturing Techniques Used in Prosthetic Dentistry. Essent Dent. 2023;2(3):135–140. doi:10.5152/EssentDent.2023.23019
11. Warreth A, Elkareimi Y. All ceramic restorations: a review of the literature. Saudi Dent J. 2020;32(8):365–372. doi:10.1016/j.sdentj.2020.05.004
12. Chen Y, Yeung AWK, Pow EHN, Tsoi JKHT. Current status and research trends of lithium disilicate in dentistry: a bibliometric analysis. J Prosthet Dent. 2021;126(4):512–522. doi:10.1016/j.prosdent. 2020.08.012
13. Erzincanlı A, Özkurt Kayahan Z, Kazazoğlu E. Protetik tedavide hibrit seramikler. Turkiye Klinikleri Prosthodontics Special Topics. 2020;6(1):17–22.
14. Jorquera G, Mahn E, Sanchez JP, Berrera S, Prado MJ, Bernasconi Stange V. Hybrid ceramics in dentistry: a literature review. J Clin Res Dent. 2018;1(2):1–5.
15. Manziuc M, Khechen AA, Negucioiu M, Poiană I, Kui A, Mesaroș A, et al. Survival Rates of Glass versus Hybrid Ceramics in Partial Prosthetic Restorations: A Scoping Review with Emphasis on Adhesive Protocols. J Clin Med. 2023;12(21):6744. doi:10.3390/jcm12216744
16. Sulaiman TA, Suliman AA, Abdulmajeed AA, Zhang Y. Zirconia restoration types, properties, tooth preparation design, and bonding. A narrative review. J Esthet Restor Dent. 2024;36(1):78–84. doi:10.1111/jerd.13151
17. Kongkiatkamon S, Rokaya D, Kengtanyakich S, Peampring C. Current classification of zirconia in dentistry: An updated review. PeerJ. 2023;11:e15669. doi:10.7717/peerj.15669
18. Ban S. Classification and properties of dental zirconia as implant fixtures and superstructures. Materials. 2021;14(17):4879. doi:10.3390/ma14174879
19. Schriwer C, Skjold A, Gjerdet NR, Øilo M. Monolithic zirconia dental crowns — internal fit, margin quality, fracture mode and load at fracture. Dent Mater. 2017;33(9):1012–1020. doi:10.1016/j.dental.2017.06.009
20. Baldissara P, Parisi C, Evangelisti E, Wandscher V, Lodi D. Fatigue resistance of cubic/tetragonal translucent zirconia crowns. Dent Mater. 2016;32(Suppl)1:e73. doi:10.1016/j.dental.2016.08.153
21. Kim W, Li XC, Bidra AS. Clinical outcomes of implant supported monolithic zirconia crowns and fixed partial dentures: a systematic review. J Prosthodont. 2023;32(2):102–107. doi:10.1111/jopr.13575
22. Karataşlı B, Alpkılıç DŞ. Zirkonyanın Diş Hekimliğinde Kullanım Alanları. Turkiye Klinikleri J Prosthodont Special Topics. 2017;3(2):94–103.
23. Turp V, Gültekin P. Zirkonyanın yapısı. Turkiye Klinikleri J Prosthodont Special Topics. 2017;3(2):77–83.
24. Pozzi A, Holst S, Fabbri G, Tallarico M. Clinical reliability of CAD/CAM cross arch zirconia bridges on immediately loaded implants placed with computer assisted/template guided surgery: a retrospective study with a follow up between 3 and 5 years. Clin Implant Dent Relat Res. 2015;17(1):e86–e96. doi:10.1111/cid.12132
25. Güneş F, Kocacıklı M, Korkmaz T. Dental İmplantolojide Polietereterketon (PEEK): Geleneksel Derleme. Selcuk Dent J . 2023;10(3):611–617. doi:10.15311/selcukdentj.1238899
26. Demir SEH, İnal CB, Aydın C. Protetik Diş Hekimliğinde Polietereterketon Materyalinin Yeri. ADO Klinik Bil Sci Dergisi. 2022;11(2):176–183. doi:10.54617/adoklinikbilimler.956409
27. Parmigiani-Izquierdo JM, Cabaña-Muñoz ME, Merino JJ, Sánchez-Pérez A. Zirconia implants and PEEK restorations for the replacement of upper molars. Int J Implant Dent. 2017;3(1):5. doi:10.1186/s40729-016-0062-2
28. Taha D, Cesar PF, Sabet A. Influence of different combinations of CAD CAM crown and customized abutment materials on the force absorption capacity in implant supported restorations – in vitro study. Dent Mater. 2022;38(1):e10–e18. doi:10.1016/j.dental.2021.12.025
29. Tekin S, Değer Y, Demirci F. Evaluation of the Use of PEEK Material in Implant Supported Fixed Restorations by Finite Element Analysis. Niger J Clin Pract. 2019;22(9):1252–1258. doi:10.4103/njcp.njcp_144_19
30. Eraslan R, Colpak ED, Kılıç K, Polat ZA. Biomechanical Properties and Biocompatibility of Implant Supported Full Arch Fixed Prosthesis Substructural Materials. Niger J Clin Pract. 2021;24(9):1373-1379. doi:10.4103/njcp.njcp_666_20
31. Gönüldaş F, Yılık B. Tam Dişsizliklerde Hibrit Protezler. Turkiye Klinikleri Prosthodontics Special Topics. 2021;7(2):34–42.
32. Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, Ohman A. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl. 1977;16:1-132.
33. Egilmez F, Ergun G, Cekic-Nagas I, Bozkaya S. Implant supported hybrid prosthesis: Conventional treatment method for borderline cases. Eur J Dent. 2015;9(3):442–448. doi:10.4103/1305-7456.163324
34. Mackert J, El-Shewy M, Pannu D, Schoenbaum T. Prosthetic complications and survival rates of metal acrylic implant fixed complete dental prostheses: A retrospective study up to 10 years. J Prosthet Dent. 2024;132(4):766–771. doi:10.1016/j.prosdent.2022.06.019
35. Taş N, Eğilmez F. İmplant destekli hibrit protezlerin yapımında kullanılan materyaller ve üretim yöntemleri. Atatürk Univ Diş Hek Fak Derg. 2021;31(2):305–315. doi:10.17567/ataunidfd.757321
36. Ayna M, Gülses A, Acil Y. A comparative study on 7-year results of “All-on-Four™” immediate-function concept for completely edentulous mandibles: metal-ceramic vs. bar-retained superstructures. Odontology. 2018;106(1):73–82. doi:10.1007/s10266-017-0304-7
37. Bhering CLB, Mesquita MF, Kemmoku DT, Noritomi PY, Consani RLX, Barão VAR. Comparison between all-on-four and all-on-six treatment concepts and framework material on stress distribution in atrophic maxilla: A prototyping guided 3D-FEA study. Mater Sci Eng C Mater Biol Appl. 2016;69:715–725. doi:10.1016/j.msec.2016.07.059
38. Shash YH, Elwakad MT, Eldosoky MAA, Dohiem MM. Evaluation of stress and strain on mandible caused by changing the bar material in hybrid prosthesis utilizing “All-on-Four” technique. Alex Eng J. 2023;62:129–143. doi:10.1016/j.aej.2022.07.030
39. Ahmadi A, Dörsam I, Stark H, Hersey S, Bourauel C, Keilig L. The all on 4 concept in the maxilla – A biomechanical analysis involving high performance polymers. J Biomed Mater Res B Appl Biomater. 2021;109(11):1698–1705. doi:10.1002/jbm.b.34826
40. Tuna SH. Overdenture Protezler. Turkiye Klinikleri Prosthodontics Special Topics. 2016;2(1):42–49.
41. Solmazgül M, Doğan A. Implant destekli overdenture protezlerde kullanılan hassas tutucular. Atatürk Univ Diş Hek Fak Derg. 2020;30(3):519–527. doi:10.17567/ataunidfd.649191
42. Ergün G, Şahin Z. Konvansiyonel ve İmplant Üstü Protezlerde Kullanılan Kaide Materyallerinde Güncel Gelişmeler. Turkiye Klinikleri J Prosthodont Special Topics. 2016;2(3):35–44.
43. Göymen AH, Kocacıklı M, Nalbant AD. Tam protezlerin güncel üretim teknikleri: geleneksel derleme. Selcuk Dent J. 2023;10(3):605–610. doi:10.15311/selcukdentj.1238453