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Temporomandibular Eklem Hastalarında Sabit Protetik Tedavide Materyal Seçimi

Yıl 2025, Cilt: 6 Sayı: 2, 21 - 38, 31.12.2025

Öz

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.

Kaynakça

  • 1. Minervini G, Fiorillo L, Russo D, Lanza A, D’Amico C, Cervino G, et al. Prosthodontic treatment in patients with temporomandibular disorders and orofacial pain and/or bruxism: a review of the literature. Prosthesis. 2022;4(2):253–62.
  • 2. Hagag G, Yoshida K, Miura H. Occlusion, prosthodontic treatment, and temporomandibular disorders: a review. J Med Dent Sci. 2000;47(1):61–66.
  • 3. Sreekumar S, Janakiram C, Mathew A. Effects of prosthetic rehabilitation on temporomandibular disorders: protocol for a randomized controlled trial. JMIR Res Protoc. 2021;10(12):e33104.
  • 4. Johansson A, Omar R, Carlsson GE. Bruxism and prosthetic treatment: a critical review. J Prosthodont Res. 2011;55(3):127–36.
  • 5. Moharir AN, Lalitha A, Waghmare S, Anuradha B, Savitha B. Bruxism: Diagnosis and Management.
  • 6. Manfredini D, Poggio CE. Prosthodontic planning in patients with temporomandibular disorders and/or bruxism: A systematic review. J Prosthet Dent. 2017;117(5):606–13.
  • 7. Weinberg LA. Vertical dimension: a research and clinical analysis. J Prosthet Dent. 1982;47(3):290–302.
  • 8. Guguvcevski L, Gigovski N, Mijoska A, Zlatanovska K, Arsova-Gigovska A. Temporomandibular disorders treatment with correction of decreased occlusal vertical dimension. Open Access Maced J Med Sci. 2017;5(7):983.
  • 9. Abduo J, Lyons K. Clinical considerations for increasing occlusal vertical dimension: a review. Aust Dent J. 2012;57(1):2–10.
  • 10. Fabbri G, Sorrentino R, Cannistraro G, Mintrone F, Bacherini L, Turrini R, Bombardelli T, Nieri M, Fradeani M. Increasing the vertical dimension of occlusion: a multicenter retrospective clinical comparative study on 100 patients with fixed tooth-supported, mixed, and implant-supported full-arch rehabilitations. Int J Periodontics Restorative Dent. 2018;38(3):323-335.
  • 11. Malkoc MA, Sevimay M, Yaprak E. The use of zirconium and feldspathic porcelain in the management of the severely worn dentition: a case report. Eur J Dent. 2009;3(1):75–8.
  • 12. El Mesbahi N, Moussaoui H, Benazouz I, Bennani A. The use of monolithic zirconia restorations for patients with bruxism. Int J Med Sci Dent Res. 2021;4(6):7–12.
  • 13. Amer R, Kürklü D, Kateeb E, Seghi RR. Three-body wear potential of dental yttrium-stabilized zirconia ceramic after grinding, polishing, and glazing treatments. J Prosthet Dent. 2014;112(5):1151–5.
  • 14. Mitov G, Heintze SD, Walz S, Woll K, Muecklich F, Pospiech P. Wear behavior of dental Y-TZP ceramic against natural enamel after different finishing procedures. Dent Mater. 2012;28(8):909–18.
  • 15. Stober T, Bermejo J, Schwindling FS, Schmitter M. Clinical assessment of enamel wear caused by monolithic zirconia crowns. J Oral Rehabil. 2016;43(8):621–9.
  • 16. Ekfeldt A, Øilo G. Wear of prosthodontic materials—an in vivo study. J Oral Rehabil. 1990;17(2):117–29.
  • 17. de Souza Melo G, Batistella EÂ, Bertazzo-Silveira E, Gonçalves TMSV, de Souza BDM, Porporatti AL, et al. Association of sleep bruxism with ceramic restoration failure: A systematic review and meta-analysis. J Prosthet Dent. 2018;119(3):354–62.
  • 18. Reitemeier B, Hänsel K, Kastner C, Weber A, Walter MH. A prospective 10-year study of metal ceramic single crowns and fixed dental prosthesis retainers in private practice settings. J Prosthet Dent. 2013;109(3):149–55.
  • 19. D’Souza NL, Jutlah EM, Deshpande RA, Somogyi-Ganss E. Comparison of clinical outcomes between single metal-ceramic and zirconia crowns. J Prosthet Dent. 2025;133(2):464–71.
  • 20. Muts E-J, van Pelt H, Edelhoff D, Krejci I, Cune M. Tooth wear: a systematic review of treatment options. J Prosthet Dent. 2014;112(4):752–9.
  • 21. Schmitter M, Bömicke W, Behnisch R, Lorenzo Bermejo J, Waldecker M, Rammelsberg P, et al. Ceramic crowns and sleep bruxism: first results from a randomized trial. J Clin Med. 2022;12(1):273.
  • 22. Baldi A, Carossa M, Comba A, Alovisi M, Femiano F, Pasqualini D, et al. Wear behaviour of polymer-infiltrated network ceramics, lithium disilicate and cubic zirconia against enamel in a bruxism-simulated scenario. Biomedicines. 2022;10(7):1682.
  • 23. Levartovsky S, Pilo R, Shadur A, Matalon S, Winocur E. Complete rehabilitation of patients with bruxism by veneered and non-veneered zirconia restorations with an increased vertical dimension of occlusion: an observational case-series study. J Prosthodont Res. 2019;63(4):440–6.
  • 24. Koenig V, Wulfman C, Bekaert S, Dupont N, Le Goff S, Eldafrawy M, et al. Clinical behavior of second-generation zirconia monolithic posterior restorations: Two-year results of a prospective study with Ex vivo analyses including patients with clinical signs of bruxism. J Dent. 2019;91:103229.
  • 25. Jerman E, Lümkemann N, Eichberger M, Hampe R, Stawarczyk B. Impact of varying step-stress protocols on the fatigue behavior of 3Y-TZP, 4Y-TZP and 5Y-TZP ceramic. Dent Mater. 2021;37(7):1073–82.
  • 26. Kongkiatkamon S, Rokaya D, Kengtanyakich S, Peampring C. Current classification of zirconia in dentistry: An updated review. PeerJ. 2023;11:e15669.
  • 27. Camelot JHN. Comparison of Zirconium and Silicate ceramic crown prosthesis in patient affected by bruxism: a systematic review. 2023.
  • 28. Heller H, Sreter D, Arieli A, Beitlitum I, Pilo R, Levartovsky S. Survival and success rates of monolithic zirconia restorations supported by teeth and implants in bruxer versus non-bruxer patients: A retrospective study. Materials. 2022;15(3):833.
  • 29. Kosinski T. Creation of the Bruxzir Hybrid to Increase Form and Function. Profitable Dent. 2019:56–9.
  • 30. Utar M, Demirtağ Z. Comparison of Translucency and Flexural Strength of Zirconia Reinforced Lithium Silicate, Zirconia and Lithium Disilicate. HRU Int J Dent Oral Res. 2023;3(2):99–103.
  • 31. Sarıkaya I, Hayran Y. Effects of dynamic aging on the wear and fracture strength of monolithic zirconia restorations. BMC Oral Health. 2018;18:1–7.
  • 32. Nakonieczny DS, Basiaga M, Sambok A, Antonowicz M, Paszenda ZK, Ziębowicz A, et al. Ageing of zirconia dedicated to dental prostheses for bruxers part 1: Influence of accelerating ageing for surface topography and mechanical properties. Rev Adv Mater Sci. 2019;58(1):189–94.
  • 33. Zafar MS. Prosthodontic applications of polymethyl methacrylate (PMMA): An update. Polymers. 2020;12(10):2299.
  • 34. Ahlers MO, Roehl JC, Jakstat HA, Kielbassa AM. Prospective case series study on the survival rates of occlusal polymethyl methacrylate veneers as a semipermanent therapy in patients with severe pathologic tooth wear. Quintessence Int. 2024;55(7):518–29.
  • 35. van Sambeek RM, de Vos R, Crins LA, Bronkhorst E, Mehta SB, Pereira-Cenci T, et al. Perception of oral health related quality of life and orofacial aesthetics following restorative treatment of tooth wear: a five-year follow-up. J Dent. 2023;136:104626.
  • 36. Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 6th ed. St. Louis: Elsevier; 2022.
  • 37. Craig RG, Powers JM, Wataha JC. Dental materials: properties and manipulation. 10th ed. St. Louis: Mosby; 2013.
  • 38. Kassardjian V, Andiappan M, Creugers NH, Bartlett D. A systematic review of interventions after restoring the occluding surfaces of anterior and posterior teeth that are affected by tooth wear with filled resin composites. J Dent. 2020;99:103388.
  • 39. Massihi R, Tassery DH. A simplified approach for restoration of worn dentition using the full mock-up concept: clinical case reports. Int J Periodontics Restorative Dent. 2018;38:189–97.
  • 40. Palacci R. Table tops restorations: a new approach for the treatment of worn dentition. 2018.
  • 41. Crins L, Opdam N, Kreulen C, Bronkhorst E, Sterenborg B, Huysmans M, et al. Randomized controlled trial on the performance of direct and indirect composite restorations in patients with severe tooth wear. Dent Mater. 2021;37(11):1645–54.
  • 42. Zhang L, Xu L, Wu D, Yu C, Fan S, Cai B. Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: a systematic review and meta-analysis. Ann Palliat Med. 2021;10(6):6122132–42.
  • 43. Al-Moraissi E, Farea R, Qasem K, Al-Wadeai M, Al-Sabahi M, Al-Iryani G. Effectiveness of occlusal splint therapy in the management of temporomandibular disorders: network meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg. 2020;49(8):1042–56.
  • 44. Hardy RS, Bonsor SJ. The efficacy of occlusal splints in the treatment of bruxism: A systematic review. J Dent. 2021;108:103621.
  • 45. Zhang S-H, He K-X, Lin C-J, Liu X-D, Wu L, Chen J, et al. Efficacy of occlusal splints in the treatment of temporomandibular disorders: a systematic review of randomized controlled trials. Acta Odontol Scand. 2020;78(8):580–9.
  • 46. Albagieh H, Alomran I, Binakresh A, Alhatarisha N, Almeteb M, Khalaf Y, et al. Occlusal splints—types and effectiveness in temporomandibular disorder management. Saudi Dent J. 2023;35(1):70–79.
  • 47. Barão VAR, Gallo AKG, Zuim PRJ, Garcia AR, Assunção WG. Effect of occlusal splint treatment on the temperature of different muscles in patients with TMD. J Prosthodont Res. 2011;55(1):19–23.
  • 48. Aljulayfi IS. Management of Prosthodontic Challenges in Tooth Wear Cases: A Narrative Review. J Pharm Bioall Sci. 2024;16(Suppl 5):S4235–8.

Yıl 2025, Cilt: 6 Sayı: 2, 21 - 38, 31.12.2025

Öz

Kaynakça

  • 1. Minervini G, Fiorillo L, Russo D, Lanza A, D’Amico C, Cervino G, et al. Prosthodontic treatment in patients with temporomandibular disorders and orofacial pain and/or bruxism: a review of the literature. Prosthesis. 2022;4(2):253–62.
  • 2. Hagag G, Yoshida K, Miura H. Occlusion, prosthodontic treatment, and temporomandibular disorders: a review. J Med Dent Sci. 2000;47(1):61–66.
  • 3. Sreekumar S, Janakiram C, Mathew A. Effects of prosthetic rehabilitation on temporomandibular disorders: protocol for a randomized controlled trial. JMIR Res Protoc. 2021;10(12):e33104.
  • 4. Johansson A, Omar R, Carlsson GE. Bruxism and prosthetic treatment: a critical review. J Prosthodont Res. 2011;55(3):127–36.
  • 5. Moharir AN, Lalitha A, Waghmare S, Anuradha B, Savitha B. Bruxism: Diagnosis and Management.
  • 6. Manfredini D, Poggio CE. Prosthodontic planning in patients with temporomandibular disorders and/or bruxism: A systematic review. J Prosthet Dent. 2017;117(5):606–13.
  • 7. Weinberg LA. Vertical dimension: a research and clinical analysis. J Prosthet Dent. 1982;47(3):290–302.
  • 8. Guguvcevski L, Gigovski N, Mijoska A, Zlatanovska K, Arsova-Gigovska A. Temporomandibular disorders treatment with correction of decreased occlusal vertical dimension. Open Access Maced J Med Sci. 2017;5(7):983.
  • 9. Abduo J, Lyons K. Clinical considerations for increasing occlusal vertical dimension: a review. Aust Dent J. 2012;57(1):2–10.
  • 10. Fabbri G, Sorrentino R, Cannistraro G, Mintrone F, Bacherini L, Turrini R, Bombardelli T, Nieri M, Fradeani M. Increasing the vertical dimension of occlusion: a multicenter retrospective clinical comparative study on 100 patients with fixed tooth-supported, mixed, and implant-supported full-arch rehabilitations. Int J Periodontics Restorative Dent. 2018;38(3):323-335.
  • 11. Malkoc MA, Sevimay M, Yaprak E. The use of zirconium and feldspathic porcelain in the management of the severely worn dentition: a case report. Eur J Dent. 2009;3(1):75–8.
  • 12. El Mesbahi N, Moussaoui H, Benazouz I, Bennani A. The use of monolithic zirconia restorations for patients with bruxism. Int J Med Sci Dent Res. 2021;4(6):7–12.
  • 13. Amer R, Kürklü D, Kateeb E, Seghi RR. Three-body wear potential of dental yttrium-stabilized zirconia ceramic after grinding, polishing, and glazing treatments. J Prosthet Dent. 2014;112(5):1151–5.
  • 14. Mitov G, Heintze SD, Walz S, Woll K, Muecklich F, Pospiech P. Wear behavior of dental Y-TZP ceramic against natural enamel after different finishing procedures. Dent Mater. 2012;28(8):909–18.
  • 15. Stober T, Bermejo J, Schwindling FS, Schmitter M. Clinical assessment of enamel wear caused by monolithic zirconia crowns. J Oral Rehabil. 2016;43(8):621–9.
  • 16. Ekfeldt A, Øilo G. Wear of prosthodontic materials—an in vivo study. J Oral Rehabil. 1990;17(2):117–29.
  • 17. de Souza Melo G, Batistella EÂ, Bertazzo-Silveira E, Gonçalves TMSV, de Souza BDM, Porporatti AL, et al. Association of sleep bruxism with ceramic restoration failure: A systematic review and meta-analysis. J Prosthet Dent. 2018;119(3):354–62.
  • 18. Reitemeier B, Hänsel K, Kastner C, Weber A, Walter MH. A prospective 10-year study of metal ceramic single crowns and fixed dental prosthesis retainers in private practice settings. J Prosthet Dent. 2013;109(3):149–55.
  • 19. D’Souza NL, Jutlah EM, Deshpande RA, Somogyi-Ganss E. Comparison of clinical outcomes between single metal-ceramic and zirconia crowns. J Prosthet Dent. 2025;133(2):464–71.
  • 20. Muts E-J, van Pelt H, Edelhoff D, Krejci I, Cune M. Tooth wear: a systematic review of treatment options. J Prosthet Dent. 2014;112(4):752–9.
  • 21. Schmitter M, Bömicke W, Behnisch R, Lorenzo Bermejo J, Waldecker M, Rammelsberg P, et al. Ceramic crowns and sleep bruxism: first results from a randomized trial. J Clin Med. 2022;12(1):273.
  • 22. Baldi A, Carossa M, Comba A, Alovisi M, Femiano F, Pasqualini D, et al. Wear behaviour of polymer-infiltrated network ceramics, lithium disilicate and cubic zirconia against enamel in a bruxism-simulated scenario. Biomedicines. 2022;10(7):1682.
  • 23. Levartovsky S, Pilo R, Shadur A, Matalon S, Winocur E. Complete rehabilitation of patients with bruxism by veneered and non-veneered zirconia restorations with an increased vertical dimension of occlusion: an observational case-series study. J Prosthodont Res. 2019;63(4):440–6.
  • 24. Koenig V, Wulfman C, Bekaert S, Dupont N, Le Goff S, Eldafrawy M, et al. Clinical behavior of second-generation zirconia monolithic posterior restorations: Two-year results of a prospective study with Ex vivo analyses including patients with clinical signs of bruxism. J Dent. 2019;91:103229.
  • 25. Jerman E, Lümkemann N, Eichberger M, Hampe R, Stawarczyk B. Impact of varying step-stress protocols on the fatigue behavior of 3Y-TZP, 4Y-TZP and 5Y-TZP ceramic. Dent Mater. 2021;37(7):1073–82.
  • 26. Kongkiatkamon S, Rokaya D, Kengtanyakich S, Peampring C. Current classification of zirconia in dentistry: An updated review. PeerJ. 2023;11:e15669.
  • 27. Camelot JHN. Comparison of Zirconium and Silicate ceramic crown prosthesis in patient affected by bruxism: a systematic review. 2023.
  • 28. Heller H, Sreter D, Arieli A, Beitlitum I, Pilo R, Levartovsky S. Survival and success rates of monolithic zirconia restorations supported by teeth and implants in bruxer versus non-bruxer patients: A retrospective study. Materials. 2022;15(3):833.
  • 29. Kosinski T. Creation of the Bruxzir Hybrid to Increase Form and Function. Profitable Dent. 2019:56–9.
  • 30. Utar M, Demirtağ Z. Comparison of Translucency and Flexural Strength of Zirconia Reinforced Lithium Silicate, Zirconia and Lithium Disilicate. HRU Int J Dent Oral Res. 2023;3(2):99–103.
  • 31. Sarıkaya I, Hayran Y. Effects of dynamic aging on the wear and fracture strength of monolithic zirconia restorations. BMC Oral Health. 2018;18:1–7.
  • 32. Nakonieczny DS, Basiaga M, Sambok A, Antonowicz M, Paszenda ZK, Ziębowicz A, et al. Ageing of zirconia dedicated to dental prostheses for bruxers part 1: Influence of accelerating ageing for surface topography and mechanical properties. Rev Adv Mater Sci. 2019;58(1):189–94.
  • 33. Zafar MS. Prosthodontic applications of polymethyl methacrylate (PMMA): An update. Polymers. 2020;12(10):2299.
  • 34. Ahlers MO, Roehl JC, Jakstat HA, Kielbassa AM. Prospective case series study on the survival rates of occlusal polymethyl methacrylate veneers as a semipermanent therapy in patients with severe pathologic tooth wear. Quintessence Int. 2024;55(7):518–29.
  • 35. van Sambeek RM, de Vos R, Crins LA, Bronkhorst E, Mehta SB, Pereira-Cenci T, et al. Perception of oral health related quality of life and orofacial aesthetics following restorative treatment of tooth wear: a five-year follow-up. J Dent. 2023;136:104626.
  • 36. Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 6th ed. St. Louis: Elsevier; 2022.
  • 37. Craig RG, Powers JM, Wataha JC. Dental materials: properties and manipulation. 10th ed. St. Louis: Mosby; 2013.
  • 38. Kassardjian V, Andiappan M, Creugers NH, Bartlett D. A systematic review of interventions after restoring the occluding surfaces of anterior and posterior teeth that are affected by tooth wear with filled resin composites. J Dent. 2020;99:103388.
  • 39. Massihi R, Tassery DH. A simplified approach for restoration of worn dentition using the full mock-up concept: clinical case reports. Int J Periodontics Restorative Dent. 2018;38:189–97.
  • 40. Palacci R. Table tops restorations: a new approach for the treatment of worn dentition. 2018.
  • 41. Crins L, Opdam N, Kreulen C, Bronkhorst E, Sterenborg B, Huysmans M, et al. Randomized controlled trial on the performance of direct and indirect composite restorations in patients with severe tooth wear. Dent Mater. 2021;37(11):1645–54.
  • 42. Zhang L, Xu L, Wu D, Yu C, Fan S, Cai B. Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: a systematic review and meta-analysis. Ann Palliat Med. 2021;10(6):6122132–42.
  • 43. Al-Moraissi E, Farea R, Qasem K, Al-Wadeai M, Al-Sabahi M, Al-Iryani G. Effectiveness of occlusal splint therapy in the management of temporomandibular disorders: network meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg. 2020;49(8):1042–56.
  • 44. Hardy RS, Bonsor SJ. The efficacy of occlusal splints in the treatment of bruxism: A systematic review. J Dent. 2021;108:103621.
  • 45. Zhang S-H, He K-X, Lin C-J, Liu X-D, Wu L, Chen J, et al. Efficacy of occlusal splints in the treatment of temporomandibular disorders: a systematic review of randomized controlled trials. Acta Odontol Scand. 2020;78(8):580–9.
  • 46. Albagieh H, Alomran I, Binakresh A, Alhatarisha N, Almeteb M, Khalaf Y, et al. Occlusal splints—types and effectiveness in temporomandibular disorder management. Saudi Dent J. 2023;35(1):70–79.
  • 47. Barão VAR, Gallo AKG, Zuim PRJ, Garcia AR, Assunção WG. Effect of occlusal splint treatment on the temperature of different muscles in patients with TMD. J Prosthodont Res. 2011;55(1):19–23.
  • 48. Aljulayfi IS. Management of Prosthodontic Challenges in Tooth Wear Cases: A Narrative Review. J Pharm Bioall Sci. 2024;16(Suppl 5):S4235–8.
Toplam 48 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Protez
Bölüm Derleme
Yazarlar

Ilgın Doğan 0009-0005-9648-6096

Işıl Çekiç Nagaş 0000-0002-2768-7207

Gönderilme Tarihi 28 Temmuz 2025
Kabul Tarihi 16 Eylül 2025
Yayımlanma Tarihi 31 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 6 Sayı: 2

Kaynak Göster

APA Doğan, I., & Çekiç Nagaş, I. (2025). Temporomandibular Eklem Hastalarında Sabit Protetik Tedavide Materyal Seçimi. Van Diş Hekimliği Dergisi, 6(2), 21-38.