Okluzijske koncepcije u implantoprotetici

master's thesis

• Title (english): Occlusional concepts in implant prosthodontics
• Author: David Geštakovski
• Mentor: Ivica Pelivan (mentor)
• Committee member: Ivica Pelivan (predsjednik povjerenstva)
• Committee member: Nikša Dulčić (član povjerenstva)
• Committee member: Slađana Milardović Ortolan (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Removable Prosthodontics); Zagreb
• Defense date and country: 2018-09-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Prosthetic Dentistry

Abstract

Planiranju okluzije u sklopu implantoprotetske terapije treba posvetiti dovoljno pozornosti uzimajući u obzir sve bitne činjenice i prateći određene smjernice iz literature. U literaturi ne postoji jasan stav i jedan koncept okluzije za implantoprotetske nadomjestke, već se rabe koncepti preuzeti iz klasične protetike, s većim ili manjim modifikacijama. Uglavnom je riječ o uzajamno zaštićenoj okluziji i njezinim inačicama gdje se stražnjim zubima štite prednji prilikom maksimalne interkuspidacije, a stražnji prednjima u kliznim kretnjama. Uz ovakav koncept valja imati na umu i razliku između parodontnoga ligamenta zuba i rigidne fiksacije implantata u kosti kako bi se one premostile. Prije svega to su različit intenzitet i mehanizam pomaka pod pritiskom te percepcija. Dobrim planom okluzije i dizajnom protetske suprastrukture izbjegavaju se rizični faktori koji dovode do okluzijskoga preopterećenja. Njih moramo poznavati jer okluzijsko preopterećenje dovodi do brojnih mehaničkih komplikacija kao što su popuštanje i lom vijka, lom implantata, nadogradnje, nadomjestka ili obložnoga materijala te bioloških komplikacija u vidu resorpcije krestalne kosti, pogotovo ako je prisutna periimplantna upala. Postoji niz smjernica koje doktoru pomažu prilikom planiranja okluzijskih koncepata, ali svakoga pacijenta treba promatrati kao zaseban slučaj čijoj se situaciji treba u najvećoj mjeri prilagoditi kako bi se uz zadovoljavajuću funkciju mogućnost komplikacija svela na najmanju razinu. U ovom radu bit će prikazan niz znanstveno potkrijepljenih činjenica koje kliničaru daju uvid u biomehaniku implantoprotetske konstrukcije i sve čimbenike koji na nju utječu te zajedno s pojedinim smjernicama pomažu u planiranju idealnoga koncepta okluzije za pojedini slučaj.

Abstract (english)

Planing of occlusion within implantoprosthetic therapy should be done in detail, all relevant facts should be taken into consideration and specific guidelines from the literature should be followed. There is no general agreement in the literature and a single concept of occlusion for implant supported prosthetic. Occlusional concepts are taken from classic prosthodontics with greater or lesser modifications. Most often mutually protected occlusion and its variants are discussed, when distal teeth protect frontal teeth in maximal intercuspidation, and frontal teeth are protecting distal teeth by guiding the mandible in its movements. With this concept, it should be kept in mind that there are differences between the periodontal ligament of the tooth and the rigid fixation of implants within the bone, so they can be compensated for. First and foremost, these are the different intensity, the mechanism of movement under pressure and perception. With a good occlusional plan and proper design of the prosthetic suprastructure, the risk factors that lead to occlusional overload can be avoided. We need to be aware of them because the occlusional overload leads to numerous mechanical complications such as loosening and fracturing of the screw, the implant, the abutment or the coating material, and biological complications such as resorption of the crestal bone, especially if a peri-implant inflammation is present. There are numerous guidelines that can assist the doctor while planning a concept of occlusion, but each patient should be approached as an individual case to which we need to adapt in order to provide satisfying function and minimize the possibility of complication. This paper will present a series of facts that provide insight in biomechanics of the implant supported construction and all the factors affecting it. Together with specific guidelines, they help in planning the ideal occlusional concept for a particular case.

• Keywords: koncepti okluzije; implantoprotetika; dizajn protetske suprastrukture; biomehanika implantata; okluzijsko preopterećenje
• Keywords (english): Concepts of occlusion; implant prosthodontics; prosthetic suprastructure design; biomechanics of implant; occlusal overload
• Language: croatian
• URN:NBN: urn:nbn:hr:127:643820
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-12-17 13:59:34