Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Farklı Açılardaki Farklı Abutment Materyallerinin Kullanıldığı Maksiller Anterior Tek Diş İmplantlarda Oluşan Streslerin Analitik Olarak İncelenmesi: Bir Sonlu Elemanlar Analizi
Analytically Investigation of Stress Created in Maxillary Anterior Single Dental Implants Using Different Abutment Materials at Different Angles: A Finite Element Analysis
Said Mirza KIZMAZa, Köksal BEYDEMİRb, Süleyman AGÜLOĞLUc
aSerbest Hekim, İstanbul, Türkiye
bDicle Üniversitesi Diş Hekimliği Fakültesi, Protetik Diş Tedavisi ABD, Diyarbakır, Türkiye
cİzmir Kâtip Çelebi Üniversitesi Diş Hekimliği Fakültesi, Protetik Diş Tedavisi ABD, İzmir, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(4):898-904
doi: 10.5336/dentalsci.2022-89759
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmanın amacı, maksiller anterior bölgelerde açılı titanyum ve zirkonya abutment kullanıldığı durumlarda, okluzal streslerin implant, abutment, restorasyon ve çevre dokularda oluşturduğu streslerin analiz edilmesidir. Bu sayede başarılı bir implant uygulaması için hangi materyallerin hangi açılarda daha başarılı olduğunun tespit edilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmada stres analiz yöntemlerinden biri olan ve teknolojinin gelişmesiyle birçok alanda sıklıkla kullanılan sonlu elemanlar analizi yöntemi kullanılmıştır. Maksillar anterior tek diş implant destekli restorasyon modelleri titanyum ve zirkonya abutment materyallerinin implant ile 0° ve 25° açı yaptığı modeller bilgisayar ortamında hazırlanmıştır. Üç boyutlu olarak bilgisayar ortamında hazırlanan bu modellere çiğneme ve kesme kuvvetleri uygulanmış ve uygulanan bu kuvvetler sonucunda implantta, abutmentte, restorasyonda, implant vidasında, çevre kemik dokuda oluşan stresler incelenerek kıyaslanmıştır. Bulgular: Maksiller anterior tek diş eksikliklerinde zirkonya abutmentler 0° ve 25° açılı kullanımda kesme ve çiğneme kuvvetlerine karşı titanyum abutmentlere benzer stres birikimleri göstermiştir. Hem zirkonya hem de titanyum abutmentlerde 25° açılandırıldıklarında açısız kullanımına göre %30 oranında stres artışı görülmüştür. Abutment vidasında ise açılı kullanımda stresin 3 kat arttığı görülmüştür. Sonuç: Estetik beklentileri karşılamak için maksiller anterior bölgede kullanılan zirkonya abutmentler çiğneme ve kesme kuvvetleri karşısında oluşan stresler açısından titanyum abutmentlere benzer stresler oluşturduğundan hem açılı hem de düz kullanımının titanyum abutmentlerden farklı sonuçlar doğurmayacağı anlaşılmıştır. Abutment vidalarında 25° açılı kullanımda 3 kat fazla stres oluştuğu tespit edildiğinden tasarım ve materyal kalitesinin dikkate alınması gerektiği görülmüştür. Konu ile ilgili in vivo çalışmaların yapılması gerektiği düşünülmektedir.

Anahtar Kelimeler: Dental implant; abutment; zirkonya abutment; sonlu elemanlar analizi
ABSTRACT
 Objective: Aim of the study is analyzing the stresses caused by occlusal stresses on the implant, abutment, restoration and surrounding tissues in cases where angled titanium and zirconia abutments are used in the maxillary anterior regions. In this way, it is aimed to determine which materials and which angles should be used for a successful implant application. Material and Methods: Finite element analysis method, which is frequently used in many areas with the development of technology, was used in the study. Maxillary anterior single implant supported restoration models were prepared in computer environment where titanium and zirconia abutment materials prepared 0° and 25° angles with the implant. Chewing and shearing forces were applied to these models, which were prepared in three dimensions in the computer environment, and as a result of these applied forces, the stresses on the implant, abutment, restoration, implant screw, and surrounding bone tissue were examined and compared. Results: In maxillary anterior single tooth deficiencies zirconia abutments showed similar stress cumulations to titanium abutments when they are used with 0° and 25° angle. On both zirconia and titanium abutments, when they are tilted 25°, an increase in stress of 30% was observed compared to the non-tilted use. It is observed that the stress increased three times more on abutment screw with the use of angle. Conclusion: Since zirconia abutments used in the maxillary anterior region to meet aesthetic expectations create stresses similar to titanium abutments in terms of stresses against chewing and shear forces, it has been understood that both angled and straight use will not produce different results than titanium abutments. Abutment screws have been found to have 3 times more stress at 25° angles, so design and material quality have to be taken into consideration. It is thought that supportive in vivo studies should be performed.

Keywords: Dental implant; abutment; zirconia abutment; finite element analysis
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