Vital Abutman Dişlerin Protetik Tedavinin Tamamlanmasından Üç Yıl Sonraki Durumlarının Değerlendirilmesi

Öz

Amaç: Bu çalışmada amaç, diş hekimliği öğrencileri

tarafından yapılan sabit protezlere destek olarak kullanılan vital

abutman dişlerin, tedavi bitiminden üç yıl sonraki periapikal

durumlarının radyografik olarak değerlendirilmesidir.

Materyal-Method: Çalışmaya sabit protezin kalıcı

simantasyonu esnasında vital ve sağlam durumda olan 67

hastaya (44 kadın, 23 erkek) ait 395 diş dahil edilmiştir.

Hastaların ortalama yaşı 50,8±11,8 olarak bulunmuştur. Sabit

protezin tipi, abutman dişlerin türü,ve hastaların tedavi ile

ilgili memnuniyet durumları kaydedilmiştir. Abutman dişler

periapikal radyografiler üzerinde iki okuyucu tarafından

değerlendirilmiş ve dişlerin periapikal durumları Periapikal

İndeks Skalası’na (PAI) göre skorlanmıştır.

Bulgular: Okuyucular tarafından yapılan okumalar arasındaki

uyum 0,87 olarak bulunmuştur. Hastaların 56’sı (%83,5)

yapılan tedaviden memnun olduklarını belirtmişlerdir. Apikal

periodontitis görülme yüzdesinin en düşük olduğu diş türü

mandibular kesici dişlerdir (%3,4, p<0,05). Maksiller dişlerde

(%20) apikal periodontitis görülme yüzdesi mandibular

dişlerden (%10,6) daha yüksek bulunmuştur (p<0,05).

Sonuç: Hastaların büyük çoğunluğunun yapılan sabit

protezlerden memnun olmalarına rağmen, klinik olarak daha

iyi bir sonuç alınabilmesi için tedavi esnasında diş hekimliği

öğrencilerinin denetlenmesine daha çok önem verilmelidir.

Anahtar Kelimeler

• Sabit Protez,İntraoral Radyografi,Periapikal İndeks,Diş Hekimliği Eğitimi

The Status of Vital Abutment Teeth Three Years after Prosthodontic Treatment

Öz

Objective: The aim of this study was to radiographically

evaluate the periapical status of vital teeth that serve as

abutments to fixed metal ceramic dental prostheses (FDP)

three years after undergraduate dental students performed the

treatment.

Material-Method: The study sample consisted of 395 vital

and intact teeth prior to the permanent cementation of FDP of

44 female and 23 male patients with a mean age of 50.8±11.8

years. The type of FDP and the type of teeth, as well as the age

and gender of the patients, were recorded. Patient satisfaction

with the treatment was also determined. Each tooth was

examined on periapical radiographs and scored using the

periapical index (PAI) to determine the periapical status.

Results: Interobserver agreement between readings was

0.87. Fifty-six patients (83.5%) were satisfied with their

treatment. The percentage of apical periodontitis was found

to be the least in mandibular incisors (3.4%, p<0.05). Apical

periodontitis was more frequently observed in maxillary

teeth than in mandibular teeth (20% and 10.6%, respectively;

p<0.05).

Conclusions: Although patients were generally satisfied with

the treatment they received, and FDP treatment performed

by undergraduate students appears to be satisfactory, more

emphasis must be placed on the supervision of students to

obtain better results.

Anahtar Kelimeler

• Fixed Dental Prostheses,Intraoral Radiography,Periapical Index,Undergraduate Dental Education

Kaynakça

1. 1. Kontakiotis EG, Filippatos CG, Stefopoulos S, Tzanetakis GN. A prospective study of the incidence of asymptomatic pulp necrosis following crown preparation. Int Endo J 2015; 48: 512-517. 2. Christensen GJ. Avoiding pulpal death during fixed prosthodontic procedures. J Am Dent Assoc 2002; 133: 1563-1564. 3. Michalakis K, Pissiotis A, Hirayama H, Kang K, Kafantaris N. Comparison of temperature increase in the pulp chamber during the polymerization of materials used for the direct fabrication of provisional restorations. J Prosthet Dent 2006; 96: 418-423. 4. Raustia AM, Napankangas R, Salonen AM. Complications and primary failures related to fixed metal ceramic bridge prostheses made by dental students. J Oral Rehabil 1998; 25: 677-680. 5. Al-Khreisat AS. Early endodontic complications following fixed prosthodontic restorations. JRMS 2010; 17: 36-41. 6. Valderhaug J, Jokstad A, Ambjornsen E, Norheim PW. Assessment of the periapical and clinical status of crowned teeth over 25 years. J Dent 1997; 25: 97-105. 7. Ørstavik D, Kerekes K, Eriksen HM. The periapical index: A scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 1986; 2: 20-34. 8. Pjetursson BE, Sailer I, Zwahlen M, Hammerle CH. A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Part i: Single crowns. Clin Oral Implants Res 2007; 18(3): 73-85. 9. Jackson CR, Skidmore AE, Rice RT. Pulpal evaluation of teeth restored with fixed prostheses. J Prosthet Dent 1992; 67: 323-325. 10. Meeuwissen R, Eschen S. Prosthodontic treatment and retreatment of 845 servicemen. J Prosthet Dent 1985; 53: 425-427. 11. Jokstad A, Mjor IA. Ten years’ clinical evaluation of three luting cements. J Dent 1996; 24: 309-315. 12. Bergenholtz G, Nyman S. Endodontic complications following periodontal and prosthetic treatment of patients with advanced periodontal disease. J Periodontol 1984; 55: 63-68. 13. Karlsson S. A clinical evaluation of fixed bridges, 10 years following insertion. J Oral Rehabil 1986; 13: 423-432. 14. Swartz B, Svenson B, Palmqvist S. Long-term changes in marginal and periapical periodontal conditions in patients with fixed prostheses: A radiographic study. J Oral Rehabil 1996; 23:101-107. 15. Cheung GS, Lai SC, Ng RP. Fate of vital pulps beneath a metal-ceramic crown or a bridge retainer. Int Endod J 2005; 38: 521-530.