Hex ve non-hex vidalı dayanaklarla hazırlanan implant üstü restorasyonların sonlu elemanlar analiz yöntemi ile karşılaştırılması
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Dosyalar
Tarih
2021
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Gelişmekte olan diş hekimliği pratiğinde diş eksikliklerinin tedavisinde implant uygulamaları çok önemli yer tutmaktadır. Protetik diş tedavisi uygulamalarında geleneksel olarak diş eksikliği durumlarında kron köprü protezleri veya hareketli bölümlü protezler uygulanmaktadır. Ancak gelişen implant tedavileri sayesinde bu gibi uygulamaların yerine implant tedavisiyle hastanın kaybedilen dişinin yerine implant üzeri restorasyon yapılarak fonksiyonun iadesi sağlanmış olur. İmplant üstü protezler simante veya vidalı olarak iki çeşit uygulanabilir. Bu çalışmada incelediğimiz tip protezler vidalı dayanaklar kullanarak hazırlanan protezlerdir. Bu çalışmanın amacı, rutin implant üstü köprü restorasyonların tedavilerinde kullanılan non-hex yapıya sahip vidalı dayanakların yerine hex yapıya sahip vidalı dayanak kullanıldığında okluzal kuvvetlere karşı herhangi bir biyomekanik avantajın olup olmadığının stres analiz yöntemiyle incelenmesi ve her iki sisteminde kendi içinde dayanıklılıklarının ölçülmesidir. Gereç ve Yöntem: Bu çalışmada; aynı çap ve boya sahip (4.1mm-10 mm) 2 adet implant alt çene arka bölgede ikinci premolar ve ikinci molar bölgeye tamamen paralel biçimde yerleştirilmek üzere seçilmiştir. Toplam iki adet model oluşturulmuş ve modellerden biri için hekzagonal yapıda implant dayanak bağlantı tasarımına sahip dayanaklar seçilirken diğeri içinse klinik pratikte implant üzeri köprü restorasyonlarında sıklıkla kullanılan non-hekzagonal bağlantı tasarımlı dayanaklar sanal ortamda yerleştirilmek üzere seçilmiştir. Bu seçilen dayanaklar üzerine üç üyeli vida destekli bir metal destekli seramik köprü restorasyon sanal ortamda yerleştirilmiş ve kronların belirli noktalarından dik ve oblik yönde kuvvet ayrı ayrı uygulanarak, toplam 4 adet çalışma grubu elde edilmiştir. Uygulanan kuvvetler sonucunda implant boyun bölgesinde, vidada ve dayanakta meydana gelen Von Mises gerilme değerleri ayrıca kortikal ve spongioz kemikte oluşan maksimum ve minimum principal stres değerleri sonlu elemanlar stres analiz yöntemi yardımıyla incelenmiştir. Bulgular: Hex ve non-hex bağlantı tasarımı olan modeller arasında implant bileşenleri üzerinde farklı stres değerleri gözlenirken kemik üzerinde benzer değerler elde edilmiştir. Bağlantıdaki altıgen tasarımın antirotasyonel etkisi bu stres değerlerinin farklı olmasını etkilemiştir. Ayrıca implant üzerine gelen kuvvetlerden oblik kuvvetler dikey kuvvetlere göre stresi daha fazla arttırıcı yönde etki göstermiştir. Sonuç: Her iki sistemde sınır değerler aşılmadığından kullanılabilir sistemlerdir. Ancak oluşan stres değerlerine bakıldığında hex sistemlerde implant ve iç vidaya gelen stres değerleri non-hex sistemlere göre daha düşüktür. Bu sebeple iki implant arası açı 30 derece aşılmadığı durumlarda hex sistemlerin kullanımının uygun olduğu düşünülmektedir. Anahtar Kelimler: İmplant, dayanak, hekzagonal bağlantı, sonlu elemanlar analizi.
Introduction and Aim: Implant treatments have an important role in the rehabilitation of dental deficiencies in developing dentistry practice. In cases of tooth deficiency, traditional treatment options are crowns, bridges and partial dentures.However, due to the developing implant treatments, the implant treatment is replaced with the restoration of the patient's lost tooth, and the function is returned by replacing such applications. Implant prostheses can be applied in two types as cemented or screwed. The types of prostheses we examine in this study are prostheses prepared using screw abutments. The aim of this study is to examine whether there is any biomechanical advantage against occlusal forces when screw abutments with hex structure are used instead of screw abutments with non-hex structure used in the treatment of routine over implant bridge restorations, and to measure their durability in both systems. Materials and Methods: In this study; 2 implants with the same diameter and length (4.1 mm-10 mm) were selected to be placed completely parallel to the first premolar and second molar regions in the posterior region of the lower jaw. A total of two models were created, and for one of the models, abutments with a hexagonal implant abutment design were selected, and for the other, abutments with non-hexagonal connection design, which are frequently used in clinical practice in bridge restorations over implants, were selected to be placed in virtual environment. A three-member, screw-supported, metal-supported ceramic bridge restoration was placed on these selected abutments in a virtual environment, and a total of 4 study groups were obtained by applying vertical and oblique force separately from certain points of the crowns. Von Mises stress values occurring in the implant neck region, screw and abutment as a result of the applied forces, as well as the maximum and minimum principal stress values in cortical and cancellous bone were analyzed with the help of finite element stress analysis method. Results: While different stress values were observed on the implant components between the hex and non-hex connection designs, similar values were obtained on the bone. The antirotational effect of the hexagonal design in the connection affected the difference of these stress values. In addition, oblique forces from the forces on the implant increased the stress more than the vertical forces. Conclusion: Border limit values are not exceeded in both systems, they are usable systems. However, considering the resulting stress values, the stress values on the implant and internal screw in hex systems are lower than in non-hex systems. For this reason, it is thought that the use of hex systems is appropriate when the angle between two implants is not exceeded 30 degrees.
Introduction and Aim: Implant treatments have an important role in the rehabilitation of dental deficiencies in developing dentistry practice. In cases of tooth deficiency, traditional treatment options are crowns, bridges and partial dentures.However, due to the developing implant treatments, the implant treatment is replaced with the restoration of the patient's lost tooth, and the function is returned by replacing such applications. Implant prostheses can be applied in two types as cemented or screwed. The types of prostheses we examine in this study are prostheses prepared using screw abutments. The aim of this study is to examine whether there is any biomechanical advantage against occlusal forces when screw abutments with hex structure are used instead of screw abutments with non-hex structure used in the treatment of routine over implant bridge restorations, and to measure their durability in both systems. Materials and Methods: In this study; 2 implants with the same diameter and length (4.1 mm-10 mm) were selected to be placed completely parallel to the first premolar and second molar regions in the posterior region of the lower jaw. A total of two models were created, and for one of the models, abutments with a hexagonal implant abutment design were selected, and for the other, abutments with non-hexagonal connection design, which are frequently used in clinical practice in bridge restorations over implants, were selected to be placed in virtual environment. A three-member, screw-supported, metal-supported ceramic bridge restoration was placed on these selected abutments in a virtual environment, and a total of 4 study groups were obtained by applying vertical and oblique force separately from certain points of the crowns. Von Mises stress values occurring in the implant neck region, screw and abutment as a result of the applied forces, as well as the maximum and minimum principal stress values in cortical and cancellous bone were analyzed with the help of finite element stress analysis method. Results: While different stress values were observed on the implant components between the hex and non-hex connection designs, similar values were obtained on the bone. The antirotational effect of the hexagonal design in the connection affected the difference of these stress values. In addition, oblique forces from the forces on the implant increased the stress more than the vertical forces. Conclusion: Border limit values are not exceeded in both systems, they are usable systems. However, considering the resulting stress values, the stress values on the implant and internal screw in hex systems are lower than in non-hex systems. For this reason, it is thought that the use of hex systems is appropriate when the angle between two implants is not exceeded 30 degrees.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry, Implant, abutment, hexagonal connection, finite element analysis.
