Publication: Gövde uzunlugunun zirkonya alt yapılı sabit parsiyel protezlerin klinik başarısına etkisi
Abstract
1.ÖZET Bu çalışmanın amacı, gövde uzunluğunun yttria ile güçlendirilmiş zirkonya alt yapılı sabit parsiyel protezlerin klinik başarısına ve marjinal adaptasyonuna etkisinin değerlendirilmesidir. CAD/ CAM sistemi ile üretilen (LAVA, 3M ESPE) 34 adet sabit parsiyel protez 25 hastaya uygulandı. Sabit parsiyel protezler gövde uzunluğuna göre; (1) 3 üye ve (2) 4 üye restorasyonlar olarak 2 gruba ayrıldı. Üst yapı porseleni olarak e-max Ceram (Ivoclar) kullanıldı. Restorasyonlar, simantasyonu takiben başlangıç, 6.ay, 12. ay, 18. ay, 24. ay, ve 30. ayda CDA kriterleri, plak ve gingival indeks ölçümleri ve hasta memnuniyeti değerlendirme kriterleri ile değerlendirildi. Marjinal ve internal adaptasyon ölçümleri ışık mikroskobu altında silikon replika tekniği ile yapıldı. İstatistiksel analiz için “Kruskal Wallis” ve “Wilcoxon Signed Ranks” testleri kullanıldı. Takip süresi boyunca alt yapı kırığına rastlanmadı. İki adet restorasyonda 3. ve 6. aylarda desimantasyon gözlendi. Ortalama marjinal aralık değerleri uzun gövde mesafesine sahip restorasyonlarda 70,92(±40,02) µm, kısa gövde mesafesine sahip restorasyonlarda 88,01(±54,34) µm olarak bulundu. En yüksek internal aralık değeri okluzal bölgede; en düşük internal aralık değeri ise marjinal bölgede gözlendi (P<0.05). Gövde uzunluğuna bağlı istatistiksel olarak anlamlı fark gözlenmedi. Tüm klinik değerlendirme kriterleri göz önüne alındığında ortalama 18 aylık değerlendirme periyodunda 34 adet zirkonya restorasyon için klinik olarak kabul edilebilir değerler kaydedilmiştir. Bu erken dönem sonuçlara dayanarak, zirkonya alt yapılı sabit parsiyel protezlerin uzun gövde mesafesi olan posterior bölge restorasyonlarında ümit verici olduğu söylenebilir. Anahtar Sözcükler: marjinal uyum, sabit parsiyel protez, tam seramik , uzun gövde mesafesi, zirkonya 2.
The Effect Of Span Length On Clinical Performance Of Y-TZP Fixed Partial Dentures The aim of this study was to evaluate the effect of span length on clinical performance and adaptation of Y-TZP fixed partial dentures. Thirty four zirconia FPDs using a CAD/ CAM system (LAVA, 3M Espe) were placed to 25 patients. FPDs were divided into two groups according to span lengths; (1) 3 units and (2) 4 units. Frameworks were layered with e-max Ceram (Ivoclar). A self adhesive luting cement, G-Cem Automix (GC) was used. Restorations were clinically assessed at baseline, 6, 12, 18, 24, 30 months after cementation by using ‘California Dental Association Criteria’, plaque and gingival indexes and patients satisfaction criteria. The marginal and internal adaptation was measured under an optical microscope using silicone replica technique. “Kruskal Wallis” and “Wilcoxon Signed Ranks” tests were used for statistical analysis (P<0.05). No framework fracture was observed. One restoration showed veneer porcelain chipping after 6 months; 2 restorations were debonded at 3rd and 6th months, respectively. The mean marginal gaps were 70,92(±40,02) µm for extended span length Y-TZP FPDs and 88,01(±54,34) µm for short span length Y-TZP FPDs. The highest gap value was observed at the occlusal area and lowest one at the marginal area.(P<0,05) There was no significant difference in relation to span length. Regarding all of the clinical evaluation criteria all 34 zirconia FPDs exhibited clinically acceptable scores within an average evaluation time of 18 months. Relying on these early results, zirconia fixed partial dentures even with long span lengths seems to be promising in the posterior area. Key Words: all-ceramic, fixed dental prostheses, long span, marginal fit, zirconia.
The Effect Of Span Length On Clinical Performance Of Y-TZP Fixed Partial Dentures The aim of this study was to evaluate the effect of span length on clinical performance and adaptation of Y-TZP fixed partial dentures. Thirty four zirconia FPDs using a CAD/ CAM system (LAVA, 3M Espe) were placed to 25 patients. FPDs were divided into two groups according to span lengths; (1) 3 units and (2) 4 units. Frameworks were layered with e-max Ceram (Ivoclar). A self adhesive luting cement, G-Cem Automix (GC) was used. Restorations were clinically assessed at baseline, 6, 12, 18, 24, 30 months after cementation by using ‘California Dental Association Criteria’, plaque and gingival indexes and patients satisfaction criteria. The marginal and internal adaptation was measured under an optical microscope using silicone replica technique. “Kruskal Wallis” and “Wilcoxon Signed Ranks” tests were used for statistical analysis (P<0.05). No framework fracture was observed. One restoration showed veneer porcelain chipping after 6 months; 2 restorations were debonded at 3rd and 6th months, respectively. The mean marginal gaps were 70,92(±40,02) µm for extended span length Y-TZP FPDs and 88,01(±54,34) µm for short span length Y-TZP FPDs. The highest gap value was observed at the occlusal area and lowest one at the marginal area.(P<0,05) There was no significant difference in relation to span length. Regarding all of the clinical evaluation criteria all 34 zirconia FPDs exhibited clinically acceptable scores within an average evaluation time of 18 months. Relying on these early results, zirconia fixed partial dentures even with long span lengths seems to be promising in the posterior area. Key Words: all-ceramic, fixed dental prostheses, long span, marginal fit, zirconia.