Okluzijska načela pri izradi implantoprotetskih radova

professional thesis

• Title (english): Occlusal principles in implant prosthodontics
• Author: Josip Vukšić
• Mentor: Domagoj Žabarović (mentor)
• Committee member: Iva Alajbeg (predsjednik povjerenstva)
• Committee member: Tomislav Badel (član povjerenstva)
• Committee member: Domagoj Žabarović (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Removable Prosthodontics); Zagreb
• Defense date and country: 2019-04-04, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Prosthetic Dentistry

Abstract

Okluzija ima važnu ulogu u izradi kako klasičnih protetskih radova tako i u implantoprotetskoj terapiji. Nepravilno uspostavljeni okluzijski odnosi mogu dovesti do bioloških i tehničkih komplikacija. Biološke komplikacije se odnose na gubitak kosti oko implantata, a tehničke komplikacije se odnose na lom implantata i narušavanje integriteta protetske komponente rada.
Za razumijevanje posebnosti okluzijskih načela u implantoprotetici, bitno je poznavati razlike između implantata i zuba. Ključna je razlika u povezanosti impantata i zuba s kosti: zub je vezan parodontnim ligamentom za kost, dok je implantat vezan oseointegracijom. U usporedbi sa implantatom, zub zbog parodontnog ligamenta ima povoljniji prijenos sila na okolnu kost kako aksijalnih tako i horizontalnih, ima veći stupanj pomičnosti te sadrži proprioceptore koji refleksnim lukom mogu zaštiti zub od preopterećenja.
Postoji mali broj istraživanja koje se bave utjecajem okluzijskog preopterećenja na nastanak bioloških komplikacija, te su njihovi rezultati neujednačeni. Sa sigurnošću se može zaključiti da okluzijsko preopterećenje dovodi do većeg pogoršanja gubitka kosti oko implantata ako je prisutan plak i upala u periimplantnom tkivu, te da preopterećenje dovodi do većeg broja tehničkih komplikacija. Preporučuju se daljnja istraživanja.
Implantat je potrebno zaštititi od nepovoljnog utjecaja okluzijskog preopterećenja i štetnog djelovanja kosih sila. To se postiže uspostavom okluzije usmjerene zaštiti implantata, implant protected occlusion, te specifičnom modelacijom protetskog rada. Okluzija usmjerena zaštiti implantata se temelji na uzajamno zaštićenoj okluziji uz određene prilagodbe. U planiranju treba uzeti u obzir cjelokupno stanje stomatognatog sustava: stupanj bezubosti, stanje u nasuprotnoj čeljusti, prisustvo parafaunkcija. Uzimajući sve u obzir, planiranje okluzije zahtijeva individualni pristup.

Abstract (english)

Occlusion plays an important role both in classic prosthodontics and implant prosthetic therapy. Uneven occlusal relations can lead to biological and technical complications. Biological complications include losing marginal bone around the implant and technical complications include fracture of the implant and losing the integrity of the prosthetic work on implants.
To understand specific occlusal principles in implant prosthodontics, it is important to understand the differences between the tooth and the implant. The key difference is the connection with the bone: tooth has the periodontal ligament while the implant is osseointegrated in the bone. Compared with the implant, because of the periodontal ligament, the tooth has much favourable transition of both axial and horizontal occlusal forces on the surrounding bone as well as greater level of mobility and proprioceptors that can protect the tooth form occlusal overload using reflex mechanisms.
There is a lack of scientific research regarding the influence of the occlusal overload on the onset of the biological complications and the results are often contrasting. It can be concluded with certainty that occlusal overload leads to quicker bone loss when plaque and inflamation are present in periimplant tissue and to onset of technical complications. Further investigations are recommended.
It is important to protect the implant from occlusal overload and non-axial forces that can cause damage by using implant protected occlusion and specific modelling of prosthetic work. Implant protected occlusion is based on mutually protected occlusion with some modifications. Planning of implant therapy should take into consideration the state of the entire stomatognathic system; number of missing teeth, condition of the opposing jaw, presence of the parafunctional activity. Taking into consideration all of the abovementioned factors, occlusal principles in implant prosthetic therapy should be individually planed.

• Keywords: implantat zaštićena okluzija; okluzijsko preopterećenje; implantoprotetika
• Keywords (english): implant protected occlusion; occlusal overload; implant prosthodontics
• Language: croatian
• URN:NBN: urn:nbn:hr:127:448036
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra dentalne medicine (sveučilišni/a magistar/magistra dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-10-07 08:48:21