{"id":1048,"date":"2024-03-22T14:35:09","date_gmt":"2024-03-22T14:35:09","guid":{"rendered":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/?post_type=chapter&#038;p=1048"},"modified":"2025-06-10T12:22:45","modified_gmt":"2025-06-10T12:22:45","slug":"periodontal-hazirlik","status":"publish","type":"chapter","link":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/chapter\/periodontal-hazirlik\/","title":{"raw":"Periodontal Haz\u0131rl\u0131k","rendered":"Periodontal Haz\u0131rl\u0131k"},"content":{"raw":"<div>Periodontal haz\u0131rl\u0131k genellikle cerrahi i\u015flemleri takip eden s\u00fcrede yap\u0131l\u0131r. Bununla birlikte, hastan\u0131n tart\u0131r birikimi a\u015f\u0131r\u0131 oldu\u011funda, enfeksiyona neden olmamak i\u00e7in, detertraj i\u015flemlerinin di\u015f \u00e7ekiminden \u00f6nce yap\u0131lmas\u0131 tavsiye edilir. Periodontal tedavi restoratif tedaviden \u00f6nce mutlaka tamamlanm\u0131\u015f olmal\u0131d\u0131r. Geriye kalan di\u015fler, \u00f6zellikle HBP deste\u011fi olanlar, periodontal destekleri a\u00e7\u0131s\u0131ndan de\u011ferlendirilmeli ve tedavileri yap\u0131lmal\u0131d\u0131r.<\/div>\r\n<div><\/div>\r\n<div>Periodontal tedavi;<\/div>\r\n<ul>\r\n \t<li>Periodontal hastal\u0131\u011fa neden olan etyolojik fakt\u00f6rleri kald\u0131rmak ve kontrol etmek,<\/li>\r\n \t<li>Cep derinliklerini azaltarak veya elimine ederek, sa\u011fl\u0131kl\u0131 di\u015feti olu\u011fu temin etmek,<\/li>\r\n \t<li>Travmatik olmayan, fonksiyonel okluzal ili\u015fki ve di\u015f stabilitesi elde etmek,<\/li>\r\n \t<li>Plak kontrol\u00fc ve koruma program\u0131 olu\u015fturarak, a\u011f\u0131z hijyeni motivasyonu sa\u011flamak bak\u0131m\u0131ndan \u00f6nemlidir.<\/li>\r\n<\/ul>\r\n<h2>Zay\u0131f periodontal deste\u011fe sahip di\u015flerin g\u00fc\u00e7lendirilmesi (Splintleme)<\/h2>\r\n<div>A\u011f\u0131zda mevcut di\u015flerin baz\u0131s\u0131 veya t\u00fcm\u00fc zay\u0131f periodontal deste\u011fe sahip olabilir ve HBP i\u00e7in sa\u011fl\u0131kl\u0131 destek ve stabilite olu\u015fturmalar\u0131 i\u00e7in splintlenmeye ihtiya\u00e7 duyarlar. Splintleme sabit veya hareketli olabilir.<\/div>\r\n<div><\/div>\r\n<div>Sabit splintleme; birbirleriyle ba\u011flant\u0131l\u0131 kron restorasyonlar\u0131 ile sa\u011flan\u0131r. Ama\u00e7 kuvvet uyguland\u0131\u011f\u0131nda, di\u015flerin hep birlikte diren\u00e7 g\u00f6stermeleridir. Posterior destek di\u015flerin splintlenmesi, anteroposterior y\u00f6nde dayan\u0131kl\u0131l\u0131\u011f\u0131 artt\u0131r\u0131r. Mediolateral y\u00f6nde etkili olabilmesi i\u00e7in, posterior restorasyonun birka\u00e7 tane anterior di\u015fi de i\u00e7ine almas\u0131 gerekir (\u015eekil 10-12).<\/div>\r\n<div>\r\n\r\n[caption id=\"attachment_1052\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12.jpg\"><img class=\"size-medium wp-image-1052\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-300x217.jpg\" alt=\"\u015eekil 10-12. Kanin ve premolar di\u015flere ilaveten anterior di\u015flerin splintlemeye dahil edilmesi, mediolateral y\u00f6nde de diren\u00e7 sa\u011flar.\" width=\"300\" height=\"217\" \/><\/a> <strong>\u015eekil 10-12.<\/strong> Kanin ve premolar di\u015flere ilaveten anterior di\u015flerin splintlemeye dahil edilmesi, mediolateral y\u00f6nde de diren\u00e7 sa\u011flar.[\/caption]\r\n\r\n<\/div>\r\n<div>Hareketli splintleme; uygun \u015fekilde planlanan, lingual plak veya \u00e7ift lingual bar ile birlikte, ekvator hatt\u0131 \u00fczerinde yer alan (tutuculuk g\u00f6revi olmayan) \u00e7oklu kro\u015fe kollar\u0131na sahip HBP ile sa\u011flan\u0131r (\u015eekil 10-13).<\/div>\r\n<div>\r\n<table class=\"shaded\" style=\"border-collapse: collapse;width: 50%\" border=\"0\"><caption>\u00a0<\/caption>\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 100%\">\r\n\r\n[caption id=\"attachment_1053\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a.jpg\"><img class=\"size-medium wp-image-1053\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-300x188.jpg\" alt=\"\u015eekil 10-13. a) Destek di\u015flerin periapikal g\u00f6r\u00fcnt\u00fcs\u00fc.\" width=\"300\" height=\"188\" \/><\/a> <strong>\u015eekil 10-13. a)<\/strong> Destek di\u015flerin periapikal g\u00f6r\u00fcnt\u00fcs\u00fc.[\/caption]<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 100%\">\r\n\r\n[caption id=\"attachment_1054\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b.jpg\"><img class=\"wp-image-1054 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-300x141.jpg\" alt=\"\u015eekil 10-13. b) Hareketli protezle splintleme i\u00e7in \u00e7oklu kro\u015fe tasar\u0131m\u0131: \u0130kinci molar ve ikinci premolar di\u015flerin kemik destekleri yetersiz oldu\u011fundan, bukkal kro\u015fe kollar\u0131 ekvator hatt\u0131 \u00fczerinde yerle\u015ftirilerek, tutuculuk sa\u011flamadan splintleme fonksiyonu i\u00e7in kullan\u0131lmakta.\" width=\"300\" height=\"141\" \/><\/a> <strong>\u015eekil 10-13. b)<\/strong> Hareketli protezle splintleme i\u00e7in \u00e7oklu kro\u015fe tasar\u0131m\u0131: \u0130kinci molar ve ikinci premolar di\u015flerin kemik destekleri yetersiz oldu\u011fundan, bukkal kro\u015fe kollar\u0131 ekvator hatt\u0131 \u00fczerinde yerle\u015ftirilerek, tutuculuk sa\u011flamadan splintleme fonksiyonu i\u00e7in kullan\u0131lmakta.[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<div>Splintlemeyi sabit veya hareketli yapmaya karar verirken, mevcut a\u011f\u0131z \u015fartlar\u0131 de\u011ferlendirilir. Serbest sonlu bir vakada, periodontal deste\u011finin yar\u0131s\u0131n\u0131 kaybetmi\u015f bir terminal destek di\u015fin sabit olarak splintlenmesi kom\u015fu di\u015fin sa\u011fl\u0131\u011f\u0131 iyi durumda olsa bile uygun de\u011fildir (\u015eekil 10-14).<\/div>\r\n<div>\r\n\r\n[caption id=\"attachment_1056\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14.jpg\"><img class=\"size-medium wp-image-1056\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-300x208.jpg\" alt=\"\u015eekil 10-14. Periodontal deste\u011finin yar\u0131s\u0131n\u0131 kaybetmi\u015f bir terminal destek di\u015fin sabit olarak splintlenmesi kom\u015fu di\u015fin sa\u011fl\u0131\u011f\u0131 iyi durumda olsa bile uygun de\u011fildir.\" width=\"300\" height=\"208\" \/><\/a> <strong>\u015eekil 10-14.<\/strong> Periodontal deste\u011finin yar\u0131s\u0131n\u0131 kaybetmi\u015f bir terminal destek di\u015fin sabit olarak splintlenmesi kom\u015fu di\u015fin sa\u011fl\u0131\u011f\u0131 iyi durumda olsa bile uygun de\u011fildir.[\/caption]\r\n\r\n<\/div>\r\n<div>Sabit splintleme b\u00f6yle bir durumda zay\u0131f di\u015fi g\u00fc\u00e7lendirmek yerine, sa\u011fl\u0131kl\u0131 di\u015fin deste\u011fini zay\u0131flat\u0131r. HBP durumu daha komplike hale getirip, di\u015f kayb\u0131n\u0131 h\u0131zland\u0131r\u0131r. Bu durumda en iyi tedavi se\u00e7ene\u011fi zay\u0131f destek di\u015fin \u00e7ekimi ve kom\u015fu destek di\u015fin HBP deste\u011fi olarak kullan\u0131lmas\u0131d\u0131r.<\/div>\r\n<div><\/div>\r\n<div>Serbest sonlu vakalarda tek ba\u015f\u0131na kalm\u0131\u015f izole destek di\u015flerde direkt tutucu kullan\u0131m\u0131 genellikle periodonsiyumun y\u0131k\u0131m\u0131n\u0131 h\u0131zland\u0131rarak, di\u015fin kayb\u0131na sebep olur. Bu nedenle izole di\u015flere t\u0131rnak yerle\u015ftirilip, direkt tutucu kullan\u0131lmamas\u0131 tavsiye edilir. Di\u011fer bir se\u00e7enek ise modifikasyon bo\u015flu\u011funun sabit protezle restorasyonu ve di\u015flerin splintlenmesidir (\u015eekil 10-15).<\/div>\r\n<div>\r\n<table class=\"shaded\" style=\"border-collapse: collapse;width: 50%;height: 254px\" border=\"0\"><caption>\u015eekil 10-15. Serbest sonlu vakada izole destek di\u015fin (a) sabit protezle splintlenmesi (b) periodontal deste\u011fini artt\u0131r\u0131r.<\/caption>\r\n<tbody>\r\n<tr style=\"height: 239px\">\r\n<td style=\"width: 100%;height: 239px\">\r\n\r\n[caption id=\"attachment_1057\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a.jpg\"><img class=\"wp-image-1057 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-300x220.jpg\" alt=\"\u015eekil 10-15. (a) sabit protezle splintlenme\" width=\"300\" height=\"220\" \/><\/a> <strong>a)<\/strong> sabit protezle splintlenme[\/caption]<\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px\">\r\n<td style=\"width: 100%;height: 15px\">\r\n\r\n[caption id=\"attachment_1058\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b.jpg\"><img class=\"wp-image-1058 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-300x218.jpg\" alt=\"b) periodontal deste\u011fin artt\u0131rmas\u0131.\" width=\"300\" height=\"218\" \/><\/a> <strong>\u00a0b)<\/strong> periodontal deste\u011fin artt\u0131r\u0131lmas\u0131.[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/div>\r\n<div>Periodontal deste\u011finin bir k\u0131sm\u0131n\u0131 kaybetmi\u015f posterior di\u015fler, serbest sonlu vakada stratejik a\u00e7\u0131dan \u00f6nemlidir. Kro\u015fe olmaks\u0131z\u0131n sadece t\u0131rnak kullan\u0131larak sa\u011flad\u0131klar\u0131 posterior destek sayesinde kaide hareketini azalt\u0131r ve proteze di\u015f destekli karakter kazand\u0131r\u0131rlar. Bu de\u011fi\u015fiklik protezin fonksiyonu ve hasta memnuniyetini artt\u0131r\u0131r.<\/div>","rendered":"<div>Periodontal haz\u0131rl\u0131k genellikle cerrahi i\u015flemleri takip eden s\u00fcrede yap\u0131l\u0131r. Bununla birlikte, hastan\u0131n tart\u0131r birikimi a\u015f\u0131r\u0131 oldu\u011funda, enfeksiyona neden olmamak i\u00e7in, detertraj i\u015flemlerinin di\u015f \u00e7ekiminden \u00f6nce yap\u0131lmas\u0131 tavsiye edilir. Periodontal tedavi restoratif tedaviden \u00f6nce mutlaka tamamlanm\u0131\u015f olmal\u0131d\u0131r. Geriye kalan di\u015fler, \u00f6zellikle HBP deste\u011fi olanlar, periodontal destekleri a\u00e7\u0131s\u0131ndan de\u011ferlendirilmeli ve tedavileri yap\u0131lmal\u0131d\u0131r.<\/div>\n<div><\/div>\n<div>Periodontal tedavi;<\/div>\n<ul>\n<li>Periodontal hastal\u0131\u011fa neden olan etyolojik fakt\u00f6rleri kald\u0131rmak ve kontrol etmek,<\/li>\n<li>Cep derinliklerini azaltarak veya elimine ederek, sa\u011fl\u0131kl\u0131 di\u015feti olu\u011fu temin etmek,<\/li>\n<li>Travmatik olmayan, fonksiyonel okluzal ili\u015fki ve di\u015f stabilitesi elde etmek,<\/li>\n<li>Plak kontrol\u00fc ve koruma program\u0131 olu\u015fturarak, a\u011f\u0131z hijyeni motivasyonu sa\u011flamak bak\u0131m\u0131ndan \u00f6nemlidir.<\/li>\n<\/ul>\n<h2>Zay\u0131f periodontal deste\u011fe sahip di\u015flerin g\u00fc\u00e7lendirilmesi (Splintleme)<\/h2>\n<div>A\u011f\u0131zda mevcut di\u015flerin baz\u0131s\u0131 veya t\u00fcm\u00fc zay\u0131f periodontal deste\u011fe sahip olabilir ve HBP i\u00e7in sa\u011fl\u0131kl\u0131 destek ve stabilite olu\u015fturmalar\u0131 i\u00e7in splintlenmeye ihtiya\u00e7 duyarlar. Splintleme sabit veya hareketli olabilir.<\/div>\n<div><\/div>\n<div>Sabit splintleme; birbirleriyle ba\u011flant\u0131l\u0131 kron restorasyonlar\u0131 ile sa\u011flan\u0131r. Ama\u00e7 kuvvet uyguland\u0131\u011f\u0131nda, di\u015flerin hep birlikte diren\u00e7 g\u00f6stermeleridir. Posterior destek di\u015flerin splintlenmesi, anteroposterior y\u00f6nde dayan\u0131kl\u0131l\u0131\u011f\u0131 artt\u0131r\u0131r. Mediolateral y\u00f6nde etkili olabilmesi i\u00e7in, posterior restorasyonun birka\u00e7 tane anterior di\u015fi de i\u00e7ine almas\u0131 gerekir (\u015eekil 10-12).<\/div>\n<div>\n<figure id=\"attachment_1052\" aria-describedby=\"caption-attachment-1052\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1052\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-300x217.jpg\" alt=\"\u015eekil 10-12. Kanin ve premolar di\u015flere ilaveten anterior di\u015flerin splintlemeye dahil edilmesi, mediolateral y\u00f6nde de diren\u00e7 sa\u011flar.\" width=\"300\" height=\"217\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-300x217.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-1024x742.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-768x557.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-1536x1113.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-65x47.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-225x163.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12-350x254.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-12.jpg 1656w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1052\" class=\"wp-caption-text\"><strong>\u015eekil 10-12.<\/strong> Kanin ve premolar di\u015flere ilaveten anterior di\u015flerin splintlemeye dahil edilmesi, mediolateral y\u00f6nde de diren\u00e7 sa\u011flar.<\/figcaption><\/figure>\n<\/div>\n<div>Hareketli splintleme; uygun \u015fekilde planlanan, lingual plak veya \u00e7ift lingual bar ile birlikte, ekvator hatt\u0131 \u00fczerinde yer alan (tutuculuk g\u00f6revi olmayan) \u00e7oklu kro\u015fe kollar\u0131na sahip HBP ile sa\u011flan\u0131r (\u015eekil 10-13).<\/div>\n<div>\n<table class=\"shaded\" style=\"border-collapse: collapse;width: 50%\">\n<caption>\u00a0<\/caption>\n<tbody>\n<tr>\n<td style=\"width: 100%\">\n<figure id=\"attachment_1053\" aria-describedby=\"caption-attachment-1053\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1053\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-300x188.jpg\" alt=\"\u015eekil 10-13. a) Destek di\u015flerin periapikal g\u00f6r\u00fcnt\u00fcs\u00fc.\" width=\"300\" height=\"188\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-300x188.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-1024x642.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-768x482.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-1536x963.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-65x41.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-225x141.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a-350x219.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13a.jpg 1697w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1053\" class=\"wp-caption-text\"><strong>\u015eekil 10-13. a)<\/strong> Destek di\u015flerin periapikal g\u00f6r\u00fcnt\u00fcs\u00fc.<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 100%\">\n<figure id=\"attachment_1054\" aria-describedby=\"caption-attachment-1054\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1054 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-300x141.jpg\" alt=\"\u015eekil 10-13. b) Hareketli protezle splintleme i\u00e7in \u00e7oklu kro\u015fe tasar\u0131m\u0131: \u0130kinci molar ve ikinci premolar di\u015flerin kemik destekleri yetersiz oldu\u011fundan, bukkal kro\u015fe kollar\u0131 ekvator hatt\u0131 \u00fczerinde yerle\u015ftirilerek, tutuculuk sa\u011flamadan splintleme fonksiyonu i\u00e7in kullan\u0131lmakta.\" width=\"300\" height=\"141\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-300x141.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-1024x480.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-768x360.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-1536x720.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-65x30.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-225x105.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b-350x164.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-13b.jpg 1688w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1054\" class=\"wp-caption-text\"><strong>\u015eekil 10-13. b)<\/strong> Hareketli protezle splintleme i\u00e7in \u00e7oklu kro\u015fe tasar\u0131m\u0131: \u0130kinci molar ve ikinci premolar di\u015flerin kemik destekleri yetersiz oldu\u011fundan, bukkal kro\u015fe kollar\u0131 ekvator hatt\u0131 \u00fczerinde yerle\u015ftirilerek, tutuculuk sa\u011flamadan splintleme fonksiyonu i\u00e7in kullan\u0131lmakta.<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div>Splintlemeyi sabit veya hareketli yapmaya karar verirken, mevcut a\u011f\u0131z \u015fartlar\u0131 de\u011ferlendirilir. Serbest sonlu bir vakada, periodontal deste\u011finin yar\u0131s\u0131n\u0131 kaybetmi\u015f bir terminal destek di\u015fin sabit olarak splintlenmesi kom\u015fu di\u015fin sa\u011fl\u0131\u011f\u0131 iyi durumda olsa bile uygun de\u011fildir (\u015eekil 10-14).<\/div>\n<div>\n<figure id=\"attachment_1056\" aria-describedby=\"caption-attachment-1056\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1056\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-300x208.jpg\" alt=\"\u015eekil 10-14. Periodontal deste\u011finin yar\u0131s\u0131n\u0131 kaybetmi\u015f bir terminal destek di\u015fin sabit olarak splintlenmesi kom\u015fu di\u015fin sa\u011fl\u0131\u011f\u0131 iyi durumda olsa bile uygun de\u011fildir.\" width=\"300\" height=\"208\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-300x208.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-1024x710.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-768x533.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-1536x1066.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-65x45.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-225x156.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14-350x243.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-14.jpg 1695w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1056\" class=\"wp-caption-text\"><strong>\u015eekil 10-14.<\/strong> Periodontal deste\u011finin yar\u0131s\u0131n\u0131 kaybetmi\u015f bir terminal destek di\u015fin sabit olarak splintlenmesi kom\u015fu di\u015fin sa\u011fl\u0131\u011f\u0131 iyi durumda olsa bile uygun de\u011fildir.<\/figcaption><\/figure>\n<\/div>\n<div>Sabit splintleme b\u00f6yle bir durumda zay\u0131f di\u015fi g\u00fc\u00e7lendirmek yerine, sa\u011fl\u0131kl\u0131 di\u015fin deste\u011fini zay\u0131flat\u0131r. HBP durumu daha komplike hale getirip, di\u015f kayb\u0131n\u0131 h\u0131zland\u0131r\u0131r. Bu durumda en iyi tedavi se\u00e7ene\u011fi zay\u0131f destek di\u015fin \u00e7ekimi ve kom\u015fu destek di\u015fin HBP deste\u011fi olarak kullan\u0131lmas\u0131d\u0131r.<\/div>\n<div><\/div>\n<div>Serbest sonlu vakalarda tek ba\u015f\u0131na kalm\u0131\u015f izole destek di\u015flerde direkt tutucu kullan\u0131m\u0131 genellikle periodonsiyumun y\u0131k\u0131m\u0131n\u0131 h\u0131zland\u0131rarak, di\u015fin kayb\u0131na sebep olur. Bu nedenle izole di\u015flere t\u0131rnak yerle\u015ftirilip, direkt tutucu kullan\u0131lmamas\u0131 tavsiye edilir. Di\u011fer bir se\u00e7enek ise modifikasyon bo\u015flu\u011funun sabit protezle restorasyonu ve di\u015flerin splintlenmesidir (\u015eekil 10-15).<\/div>\n<div>\n<table class=\"shaded\" style=\"border-collapse: collapse;width: 50%;height: 254px\">\n<caption>\u015eekil 10-15. Serbest sonlu vakada izole destek di\u015fin (a) sabit protezle splintlenmesi (b) periodontal deste\u011fini artt\u0131r\u0131r.<\/caption>\n<tbody>\n<tr style=\"height: 239px\">\n<td style=\"width: 100%;height: 239px\">\n<figure id=\"attachment_1057\" aria-describedby=\"caption-attachment-1057\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1057 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-300x220.jpg\" alt=\"\u015eekil 10-15. (a) sabit protezle splintlenme\" width=\"300\" height=\"220\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-300x220.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-1024x750.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-768x562.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-1536x1124.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-65x48.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-225x165.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a-350x256.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15a.jpg 1646w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1057\" class=\"wp-caption-text\"><strong>a)<\/strong> sabit protezle splintlenme<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<tr style=\"height: 15px\">\n<td style=\"width: 100%;height: 15px\">\n<figure id=\"attachment_1058\" aria-describedby=\"caption-attachment-1058\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1058 size-medium\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-300x218.jpg\" alt=\"b) periodontal deste\u011fin artt\u0131rmas\u0131.\" width=\"300\" height=\"218\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-300x218.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-1024x743.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-768x557.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-1536x1114.jpg 1536w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-65x47.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-225x163.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b-350x254.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/10-15b.jpg 1652w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-1058\" class=\"wp-caption-text\"><strong>\u00a0b)<\/strong> periodontal deste\u011fin artt\u0131r\u0131lmas\u0131.<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div>Periodontal deste\u011finin bir k\u0131sm\u0131n\u0131 kaybetmi\u015f posterior di\u015fler, serbest sonlu vakada stratejik a\u00e7\u0131dan \u00f6nemlidir. Kro\u015fe olmaks\u0131z\u0131n sadece t\u0131rnak kullan\u0131larak sa\u011flad\u0131klar\u0131 posterior destek sayesinde kaide hareketini azalt\u0131r ve proteze di\u015f destekli karakter kazand\u0131r\u0131rlar. Bu de\u011fi\u015fiklik protezin fonksiyonu ve hasta memnuniyetini artt\u0131r\u0131r.<\/div>\n","protected":false},"author":3,"menu_order":3,"template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-1048","chapter","type-chapter","status-publish","hentry"],"part":223,"_links":{"self":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/1048","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/users\/3"}],"version-history":[{"count":7,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/1048\/revisions"}],"predecessor-version":[{"id":1248,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/1048\/revisions\/1248"}],"part":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/parts\/223"}],"metadata":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/1048\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/media?parent=1048"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapter-type?post=1048"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/contributor?post=1048"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/license?post=1048"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}