Turkiye Klinikleri Journal of Dental Sciences

İmplant Destekleri Üzerine Gelen KuvvetlerinAlt Çene Deformasyonuna Etkisi: Pilot Çalışma
THE INFLUENCE OF LOAD EXERTED ON IMPLANT ABUTMENTSON MANDIBULAR DEFORMATION: A PILOT STUDY
M.Kemal ÜNSAL*, Selçuk ORUÇ**
*Dt., Araştırma Görevlisi. Ankara Üniversitesi Diş Hekimliği Fakültesi Protetik Diş Tedavisi AD**, Doç., Gülhane Askeri Tıp Akademisi, Diş Hekimliği Bilimleri Enstitüsü, ANKARA
Turkiye Klinikleri J Dental Sci. 2000;6(1):7-12
Article Language: TR
Full Text
ÖZET
Amaç: Bir ya da birden çok diş eksikliği gözlenen hastalara fonksiyon, estetik ve koruyucu yaklaşımın birlikte sunulabildiği tek alternatif olan dental implantlar, günümüzde yaygın kabul gören bir tedavi yöntemi olmuştur. Doğal dişler ile implantların, kemiğe tutunma mekanizmaları, yapısal farklılıkları ve destek kemiğin kuvvetler karşısında davranış şekli gözönüne alınacak olursa biomekanik farklılıkların ortaya çıkması kaçınılmazdır. Çalışmamız altyapı olarak sadece implantların kullanıldığı bir vaka da mandibulanın ortaya koyduğu deformasyon şeklinin implant destekleri üzerine ilettiği kuvvetleri in vivo olarak incelemeyi amaçlamaktadır. Materyal ve Metod: Çalışmanın yapıldığı tarihte üç senedir Branemark protokolüne uygun bir alt sabit hareketli, üst total protez taşıyan hastanın alt çenesinin, fonksiyonel üç temel hareket karşısında gösterdiği davranış şekli, implant destekleri üzerine yerleştirilen gerilim ölçerler aracılığı ile ölçülmüştür. Bulgular: In vivo tekniklerin kullanılması ile benzer araştırmalardan ayrılan çalışmamız fonksiyonel hareketler sırasında mandibulanın ciddi deformasyonlar gösterdiğini ortaya koymuştur. Sonuç: Alt çenede osseointegre implantların rijit bir üstyapı ile birbirine bağlandığı durumlarda fonksiyonel işlemler sırasında implantlar üzerine ciddi miktarlarda aksiyel kuvvet uygulandığı görülmüştür. Bu tür kuvvetlerin uzun dönem etkileri ortaya konuncaya kadar konuyla ilgilenen klinisyenlerin özellikle kısa implantların kullanıldığı, kemik desteği az vakalarda implant sayısını arttırmayı ve/veya dengeli bir oklüzyon sağlamayı hedef edinmeleri gerekmektedir.

Anahtar Kelimeler: İmplant, osseointegrasyon, erilim-ölçer, kuvvet iletimi, mandibuler deformasyon
ABSTRACT
Purpose: Using dental implants is the treatment alternative for replacing the standard protocols such as crowns, bridges and total dentures. Currently implants are widely accepted for the level of function, esthetics and conservation of the remaining dentition. However, compared to the natural dentition, the bio-mechanical properties of dental implants are different. This study evaluates the mandibular behaviour and the effects of related stress transfer to implant abutments under functional loads in vivo. Materials and Method: The work is carried out on a volunteered female patient who was having a fixed removable implant supported denture in the mandible and a conventional full denture in the maxilla. Results: The interpreted data acquired via strain-gauges bonded on the implant abutments revealed that a considerable amount of stress is localised around the implants under functional forces if the superstructure is rigidly connected to the abutments. Conclusion: The results of this study showed that in cases where mandibular osseointegrated implants are connected with rigid superstructures considerable axial load is exerted on implant abutments. Until the long term consequences of such forces are evaluated, the clinicians should aim to increase the number of implants and achieve a balanced occlusion especially on cases where short implants are used.

Keywords: Force transfer, osseointegration, strain-gauge, dental implants, mandibular deformation

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