{"id":1065,"date":"2024-03-22T15:53:10","date_gmt":"2024-03-22T15:53:10","guid":{"rendered":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/?post_type=chapter&p=1065"},"modified":"2025-06-11T06:05:18","modified_gmt":"2025-06-11T06:05:18","slug":"destek-dis-hazirliklari","status":"publish","type":"chapter","link":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/chapter\/destek-dis-hazirliklari\/","title":{"raw":"Minede Yap\u0131lan Destek Di\u015f Haz\u0131rl\u0131klar\u0131","rendered":"Minede Yap\u0131lan Destek Di\u015f Haz\u0131rl\u0131klar\u0131"},"content":{"raw":"Destek di\u015f haz\u0131rl\u0131klar\u0131ndan \u00f6nce, te\u015fhis modellerinin analiz edilmesi ve tahmini protez planlamas\u0131n\u0131n yap\u0131lm\u0131\u015f olmas\u0131 gerekir.\r\nTe\u015fhis modellerinde, protezin giri\u015f yolu, de\u011fi\u015ftirilecek di\u015f y\u00fczeyleri ve konturlar\u0131, t\u0131rnak yuvalar\u0131 ve rehber d\u00fczlemlerin konumlar\u0131 belirlendikten sonra, destek di\u015f haz\u0131rl\u0131klar\u0131 minede veya restorasyon \u00fczerinde yap\u0131labilir.\r\n\r\nMine y\u00fczeylerinin \u015feklini de\u011fi\u015ftirirken koruyuculuk esas oldu\u011fundan, d\u00fczenleme mine s\u0131n\u0131rlar\u0131 i\u00e7inde kalmal\u0131d\u0131r. A\u015f\u0131r\u0131 miktarda d\u00fczeltme gerektiren durumlarda veya yeterli mine kal\u0131nl\u0131\u011f\u0131 olmad\u0131\u011f\u0131nda, di\u015fin kronla restorasyonu daha uygundur. Yap\u0131lan de\u011fi\u015fikli\u011fin ard\u0131ndan, mine y\u00fczeyi ye\u015fil ta\u015fla d\u00fczeltilir ve lastikle cilalan\u0131p, flor uygulan\u0131r.\r\nA\u011f\u0131z haz\u0131rl\u0131\u011f\u0131 i\u015flemi boyunca, te\u015fhis modeli analiz\u00f6r tablas\u0131nda giri\u015f yoluna uygun e\u011fimde yerle\u015ftirilmi\u015f olarak hekimin yan\u0131nda olmal\u0131d\u0131r. B\u00f6ylece elmas frez ve \u015fekil verilecek olan di\u015f y\u00fczeyi aras\u0131ndaki ili\u015fki modelden a\u011f\u0131za yans\u0131t\u0131l\u0131r (\u015eekil 10-18).\r\n\r\n\r\n\r\n
\u015eekil 10-18. Rehber d\u00fczlem haz\u0131rl\u0131\u011f\u0131 a) Analiz\u00f6r tablas\u0131ndaki modelde \u015fekillendirilen di\u015f y\u00fczeyi ve frez aras\u0131ndaki ili\u015fki b) Frez ve model aras\u0131ndaki ili\u015fki, hasta a\u011fz\u0131na yans\u0131t\u0131larak yap\u0131lan preparasyon<\/caption>\r\n
\r\n\r\n[caption id=\"attachment_1070\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-18 a)[\/caption]<\/td>\r\n<\/tr>\r\n
\r\n\r\n[caption id=\"attachment_1071\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-18 b)[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n \r\n

Rehber d\u00fczlemlerin haz\u0131rlanmas\u0131<\/h3>\r\nProtezin giri\u015f yoluna ve birbirlerine paralel olmas\u0131 gereken rehber d\u00fczlemler proksimal ve lingual di\u015f y\u00fczeylerinde haz\u0131rlan\u0131r. Rehber d\u00fczlem haz\u0131rl\u0131\u011f\u0131, destek di\u015flerin konumuna g\u00f6re farkl\u0131 \u015fekilde yap\u0131l\u0131r ve genellikle silindirik elmas veya karbid frez kullan\u0131l\u0131r (\u015eekil 10-19).\r\n\r\n[caption id=\"attachment_1072\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-19.<\/strong> Rehber d\u00fczlem haz\u0131rl\u0131\u011f\u0131nda kullan\u0131lan silindirik elmas frezler.[\/caption]\r\n\r\nDi\u015f destekli bo\u015fluklara kom\u015fu destek di\u015flerde<\/strong>, frez aproksimal y\u00fczeyin bukkal k\u00f6\u015fesinden lingual k\u00f6\u015fesine do\u011fru y\u00f6nlendirilerek, hafif kurvat\u00fcrl\u00fc bir rehber d\u00fczlem \u015fekillendirilir (\u015eekil 10-20).\r\n\r\n\r\n\r\n
\u015eekil 10-20. Di\u015f destekli bo\u015flukta silindirik elmas frezle rehber d\u00fczlem haz\u0131rl\u0131\u011f\u0131: a) Anterior b) posterior destek di\u015fteki rehber d\u00fczlemlerin birbirlerine ve giri\u015f yoluna paralel olmas\u0131 gerekir.<\/caption>\r\n
\r\n\r\n[caption id=\"attachment_1073\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-20. a)<\/strong> Anterior[\/caption]<\/td>\r\n<\/tr>\r\n
\r\n\r\n[caption id=\"attachment_1074\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-20. b)<\/strong>[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\nBu y\u00fczey, 2-4 mm okluzogingival y\u00fcksekli\u011fe sahip olan, okluzalden bak\u0131ld\u0131\u011f\u0131nda ise d\u00fcz bir y\u00fczey \u015feklinde olmayan bir kurvat\u00fcr olu\u015fturmal\u0131d\u0131r (\u015eekil 10-21).\r\n\r\n[caption id=\"attachment_1075\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-21. a)<\/strong> Di\u015f destekli bo\u015flu\u011fa kom\u015fu rehber d\u00fczlemin y\u00fcksekli\u011fi 2-4 mm\u2019dir. b)<\/strong> Haz\u0131rlanan y\u00fczey, okluzalden bak\u0131ld\u0131\u011f\u0131nda d\u00fcz de\u011fildir; aproksimal y\u00fczeyin do\u011fal kurvat\u00fcr\u00fcn\u00fc taklit eder.[\/caption]\r\n\r\nSerbest sonlu bo\u015fluklara kom\u015fu destek di\u015flerde<\/strong>, rehber d\u00fczlem y\u00fcksekli\u011fi biraz daha k\u0131sa, 1.5 -2 mm haz\u0131rlanarak (\u015eekil 10-22), bu y\u00fczeyle ili\u015fkili olan proksimal plak temas\u0131 azalt\u0131l\u0131r. B\u00f6ylece serbest sonlu kaidenin hareketine izin verilir ve destek di\u015fte olu\u015fabilecek devrilme hareketi azal\u0131r (\u015eekil 10-23).\r\n\r\n[caption id=\"attachment_1077\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-22.<\/strong> Serbest sonlu bo\u015flu\u011fa kom\u015fu rehber d\u00fczlemin y\u00fck\u00adsekli\u011fi 1.5-2 mm\u2019dir.[\/caption]\r\n\r\n[caption id=\"attachment_1078\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-23.<\/strong> Serbest sonlu bo\u015flu\u011fa kom\u015fu rehber d\u00fczlemin y\u00fcksekli\u011finin daha az olu\u015fu, min\u00f6r ba\u011flay\u0131c\u0131 ile temas\u0131 azaltarak, protezin serbest hareketine izin verir. B\u00f6ylece destek di\u015fe iletilecek tork kuvveti azal\u0131r.[\/caption]\r\n\r\nDestek di\u015flerin lingual y\u00fczeylerinde<\/strong>, rehber d\u00fczlemin okluzogingival y\u00fcksekli\u011fi 2-4 mm\u2019dir. Mezial veya distal y\u00fczden bak\u0131ld\u0131\u011f\u0131nda klinik kronun orta \u00fc\u00e7l\u00fcs\u00fcnde yer al\u0131r (\u015eekil 10-24).\r\n\r\n[caption id=\"attachment_1079\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-24.<\/strong> Lingual rehber d\u00fczlemin okluzogingival y\u00fcksekli\u011fi 2-4 mm\u2019dir ve klinik kronun orta \u00fc\u00e7l\u00fcs\u00fcnde konumlan\u0131r.[\/caption]\r\n\r\nDestek di\u015fin gingival \u00fc\u00e7te bir b\u00f6lgesinin \u015feklinin de\u011fi\u015ftirilmemesine dikkat edilir; aksi halde g\u0131da birikimi nedeniyle marjinal di\u015fetinde yaralanmalar olu\u015fur.\r\n\r\nAnterior destek di\u015flerin<\/strong> eksikli\u011finde kom\u015fu di\u015fler bo\u015flu\u011fa do\u011fru devrilir veya kayar; di\u015f diziminin esteti\u011fi bozulur.\r\n\r\nDi\u015fler devrilmemi\u015f olsa bile, kontur y\u00fcksekli\u011finin alt b\u00f6l\u00fcm\u00fcnde geni\u015f bir and\u0131rkat olu\u015fur (\u015eekil 10-25).\r\n\r\n\r\n\r\n
\u015eekil 10-25. Anterior di\u015f eksikli\u011finde, destek di\u015flerin (a ve b) kontur y\u00fcksekli\u011finin alt b\u00f6l\u00fcm\u00fcnde ve proksimale bakan y\u00fczeyde geni\u015f bir and\u0131rkat olu\u015fur.<\/caption>\r\n
\r\n\r\n[caption id=\"attachment_1080\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> a)[\/caption]<\/td>\r\n<\/tr>\r\n
\r\n\r\n[caption id=\"attachment_1081\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> b)[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\nBu y\u00fczeyde yap\u0131lacak rehber d\u00fczlem de giri\u015f yoluna paralel olmal\u0131d\u0131r (\u015eekil 10-26).\r\n\r\n[caption id=\"attachment_1083\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-26.<\/strong> Anterior rehber d\u00fczlem preparasyonu. a) Destek di\u015fin mezial and\u0131rkat\u0131 azalt\u0131l\u0131r. b) Preparasyon sonras\u0131nda geriye kalan and\u0131rkat hareketli protez i\u00e7in daha uygun olur.[\/caption]\r\n\r\nDe\u011fi\u015fiklik i\u00e7in gereken preparasyon mine s\u0131n\u0131rlar\u0131 i\u00e7inde kalmayacak kadar fazla olursa, di\u015fin kronla restorasyonu planlan\u0131r.\r\n

Kontur y\u00fcksekli\u011finin de\u011fi\u015ftirilmesi<\/h3>\r\nKro\u015fe kolu, kronun gingival ve orta \u00fc\u00e7l\u00fcs\u00fcn\u00fcn birle\u015fim yerinden daha okluzale veya insizale do\u011fru konumlanmaz. B\u00f6ylece kro\u015fenin estetik \u00f6zelli\u011fi artar ve kro\u015fe di\u015fin rotasyon merkezine yak\u0131n b\u00f6lgesine yerle\u015ferek, mekanik avantaj da sa\u011flar. Kro\u015fe kollar\u0131n\u0131n veya lingual pla\u011f\u0131n daha uygun bir konumda yerle\u015ftirilmesi i\u00e7in kontur y\u00fcksekli\u011fi de\u011fi\u015ftirilebilir.\r\n\r\nGenelde maksiller posterior di\u015fler fasiyal y\u00f6nde, mandibular di\u015fler ise lingual y\u00f6nde devrilirler ve di\u015flerin kontur y\u00fcksekli\u011finde de\u011fi\u015fiklik olu\u015fur. Protez bile\u015fenlerinin do\u011fru yerle\u015fimini sa\u011flamak i\u00e7in, e\u011fimli bir silindirik frezle mine y\u00fczeyinde d\u00fczeltme yap\u0131l\u0131r (\u015eekil 10-27 ve 10-28).\r\n\r\n[caption id=\"attachment_1084\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-27.<\/strong> Kontur y\u00fcksekli\u011finin preparasyon \u00f6ncesindeki durumu.[\/caption]\r\n\r\n[caption id=\"attachment_1085\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-28.<\/strong> Preparasyon sonras\u0131ndaki kontur y\u00fcksekli\u011fi ve ekvator hatt\u0131ndaki de\u011fi\u015fiklik.[\/caption]\r\n

Tutucu and\u0131rkatlar\u0131n artt\u0131r\u0131lmas\u0131<\/h3>\r\nMevcut and\u0131rkat miktar\u0131n\u0131n artt\u0131r\u0131lmas\u0131 veya yeni bir and\u0131rkat olu\u015fturulmas\u0131 i\u00e7in di\u015f y\u00fczeylerinin de\u011fi\u015ftirilmesi s\u0131k uygulanan bir i\u015flem de\u011fildir. B\u00f6yle bir uygulama i\u00e7in di\u015f y\u00fczeylerinin vertikale yak\u0131n ve and\u0131rkats\u0131z bir \u015fekle sahip olmas\u0131 gerekir. Bu durumda, elmas rond frez anteroposterior y\u00f6nde hareket ettirilerek, di\u015f y\u00fczeyinde hafif bir girinti olu\u015fturulur (\u015eekil 10-29 ve 10-30).\r\n\r\n[caption id=\"attachment_1087\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-29. a)<\/strong> Vestib\u00fcl ve lingual y\u00fcz\u00fcnde kontur olmayan destek di\u015f, b)<\/strong> Vestib\u00fcl y\u00fczeyde preparasyonla olu\u015fturulan hafif girinti.[\/caption]\r\n\r\n[caption id=\"attachment_1086\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-30.<\/strong> Vestib\u00fcl y\u00fczeyde anteroposterior y\u00f6nde kullan\u0131lan rond frezle hafif bir girinti \u015feklinde tutucu b\u00f6lge \u015fekillendirilir.[\/caption]\r\n\r\nGirintinin, gingival marjine paralel olmas\u0131; meziodistal uzunlu\u011funun ve okluzogingival y\u00fcksekli\u011finin 3 mm olmas\u0131 gerekir. Daha da \u00f6nemlisi, giri\u015f yoluyla ili\u015fkili olarak, planlanan kro\u015feye g\u00f6re de\u011fi\u015fmekle birlikte en az 0.25 mm\u2019lik and\u0131rkat derinli\u011fine sahip olmal\u0131d\u0131r. Ancak bu girintinin keskin olmamas\u0131 yumu\u015fak ge\u00e7i\u015fle yap\u0131lmas\u0131 gerekir; aksi halde kro\u015fenin and\u0131rkata yerle\u015fmesi ve uzakla\u015fmas\u0131 esnas\u0131nda sorun olu\u015fur (\u015eekil 10-31).\r\n\r\n[caption id=\"attachment_1088\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-31.<\/strong> Girintinin keskin k\u00f6\u015felere sahip olmamas\u0131 gerekir; aksi halde kro\u015fenin tutucu alana yerle\u015fip uzakla\u015f\u00admas\u0131 zorla\u015f\u0131r.[\/caption]\r\n

T\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131<\/h3>\r\nOkluzal t\u0131rnak yuvas\u0131: Taban\u0131 marjinal kenarda ve tepesi di\u015fin merkezinde olan \u00fc\u00e7gen \u015feklindedir. Yuvan\u0131n d\u0131\u015f kenarlar\u0131 ve \u00f6zellikle de \u00fc\u00e7genin tepesi yuvarlat\u0131lm\u0131\u015f olmal\u0131d\u0131r. Okluzal t\u0131rnak yuvas\u0131 i\u00e7in ideal geni\u015flik premolar di\u015fler i\u00e7in bukkal ve lingual t\u00fcberk\u00fcl tepelerinin aras\u0131ndaki mesafenin yakla\u015f\u0131k olarak yar\u0131s\u0131, molar di\u015fler i\u00e7in ise bundan biraz daha azd\u0131r (\u015eekil 10-32).\r\n\r\n[caption id=\"attachment_1089\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-32.<\/strong> Okluzal t\u0131rna\u011f\u0131n boyutu, di\u015fin t\u00fcberk\u00fcl tepeleri aras\u0131ndaki bukkolingual geni\u015fli\u011fin yar\u0131s\u0131 ve meziodistal geni\u015fli\u011finin \u00fc\u00e7te biri veya yar\u0131s\u0131 kadar olmal\u0131d\u0131r.[\/caption]\r\n\r\nProteze gelen kuvvetlerin vertikal y\u00f6nde iletilebilmesi i\u00e7in, t\u0131rnak yuvas\u0131n\u0131n taban\u0131 ile di\u015fin proksimal y\u00fczeyinden, uzun aks\u0131na paralel olarak \u00e7izilen do\u011fru aras\u0131ndaki a\u00e7\u0131n\u0131n 90\u00b0\u2019den az olmas\u0131 gerekir (\u015eekil 10-33).\r\n\r\n[caption id=\"attachment_1091\" align=\"alignnone\" width=\"254\"]\"\u015eekil<\/a> \u015eekil 10-33.<\/strong> T\u0131rnak yuvas\u0131n\u0131n taban\u0131 ve di\u015fin proksimal y\u00fc\u00adzeyinden di\u015fin uzun aks\u0131na paralel olarak \u00e7izilen do\u011fru aras\u0131n\u00addaki a\u00e7\u0131 90\u00b0\u2019den az olmal\u0131d\u0131r.[\/caption]\r\n\r\nDestek di\u015f normal konumunda oldu\u011funda, t\u0131rnak yuvas\u0131 rezid\u00fcel kret tepesinin merkezinde olmal\u0131d\u0131r; ancak bu durum rotasyona u\u011fram\u0131\u015f veya devrilmi\u015f di\u015fler i\u00e7in pratik bir yakla\u015f\u0131m de\u011fildir.\r\n\r\nA\u015f\u0131r\u0131 derecede meziale e\u011fimli mandibular molar di\u015flerde, di\u015fin mezial y\u00fczeyindeki t\u0131rnak yuvas\u0131n\u0131n taban\u0131 di\u015fin uzun aks\u0131na dik olacak \u015fekilde haz\u0131rlan\u0131r (\u015eekil 10-34).\r\n\r\n[caption id=\"attachment_1092\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-34.<\/strong> Meziale e\u011fimli mandibular molar di\u015fte haz\u0131r\u00adlanacak olan t\u0131rnak yuvas\u0131n\u0131n taban\u0131 di\u015fin uzun aks\u0131na dik ol\u00addu\u011funda, di\u015fin daha fazla meziale devril\u00admesi \u00f6nlenebilir.[\/caption]\r\n\r\nOkluzal t\u0131rna\u011f\u0131n en ince oldu\u011fu b\u00f6lgede en az 1 mm kal\u0131nl\u0131kta olmas\u0131 gerekti\u011finden t\u0131rnak yuvas\u0131n\u0131n derinli\u011fi, kar\u015f\u0131t arkla okluzal \u00e7at\u0131\u015fmaya neden olmayacak \u015fekilde haz\u0131rlan\u0131r. Ancak yuva \u00e7ok derin yap\u0131larak vertikal duvarlar olu\u015fturulmamal\u0131 ve t\u0131rna\u011f\u0131n destek di\u015fte horizontal y\u00f6nde stres olu\u015fturmas\u0131na izin verilmemelidir. K\u0131r\u0131lmaya yatk\u0131n hale gelen k\u0131sa ve korumas\u0131z mine prizmalar\u0131 b\u0131rak\u0131lmadan, yuva y\u00fczeylerinin t\u00fcm\u00fc, kro\u015fenin di\u015fe tork kuvveti iletmeden hafif derecede hareket etmesine izin verecek \u015fekilde yuvarlat\u0131l\u0131r. Keskin k\u00f6\u015felere sahip olan bir t\u0131rnak yuvas\u0131, \u00f6zellikle serbest sonlu kaidenin fonksiyon esnas\u0131ndaki hareketine izin vermez.\r\n\r\nMinesi zaten a\u015f\u0131nm\u0131\u015f ve ince bir mine tabakas\u0131 kalm\u0131\u015f olan abraze di\u015flerde t\u0131rnak yuvas\u0131n\u0131n do\u011frudan di\u015f \u00fczerinde haz\u0131rlanmas\u0131 yerine, di\u015fin kronla restorasyonu tercih edilir.\r\n\r\nOkluzal t\u0131rnak yuvas\u0131 rond frez, yuvarlak u\u00e7lu veya gittik\u00e7e daralan elmas frezlerle haz\u0131rlanabilir (\u015eekil 10-35).\r\n\r\n[caption id=\"attachment_1093\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-35.<\/strong> Okluzal t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda daralan silindir ve rond gibi farkl\u0131 tipte frezler kullan\u0131labilir.[\/caption]\r\n\r\nRond frez kullan\u0131ld\u0131\u011f\u0131nda, yuvada and\u0131rkat olu\u015fturulmamas\u0131na dikkat edilir (\u015eekil 10-36).\r\n\r\n[caption id=\"attachment_1094\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-36.<\/strong> T\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda rond frez kullan\u0131l\u0131rken, and\u0131rkat olu\u015fturulmamas\u0131na dikkat edilir.
a)<\/strong> Mine y\u00fczeyinin \u00fczerinde konumland\u0131r\u0131lan rond frez.
b)<\/strong> Dikey y\u00f6nde ilerletien rond frez.
c)<\/strong> Yatay y\u00f6nde ilerletilen rond frez.
d)<\/strong> Frez kald\u0131r\u0131ld\u0131\u00ad\u011f\u0131nda olu\u015fan and\u0131rkat.[\/caption]\r\n\r\nYuvarlak u\u00e7lu ve gittik\u00e7e daralan frezler and\u0131rkat olu\u015fturmadan preparasyon yapabilmeye olanak sa\u011flar (\u015eekil 10-37).\r\n\r\n[caption id=\"attachment_1095\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-37.<\/strong> T\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda daralan silindir frez kullan\u0131ld\u0131\u011f\u0131nda and\u0131rkat olu\u015fturma ihtimali azal\u0131r.
a)<\/strong> Mine y\u00fczeyinin \u00fczerinde konumland\u0131r\u0131lan daralan frez.
b)<\/strong> Dikey y\u00f6nde ilerletilen daralan frez.
c)<\/strong> Yatay y\u00f6nde ilerletilen daralan frez.
d)<\/strong> Frez kald\u0131r\u0131ld\u0131\u011f\u0131nda and\u0131rkat olu\u015fmamas\u0131.[\/caption]\r\n\r\nSe\u00e7ilen frezle \u00f6ncelikle yuvan\u0131n \u015fekli, daha sonra da ideal derinli\u011fi olu\u015fturulur (\u015eekil 10-38).\r\n\r\n[caption id=\"attachment_1097\" align=\"alignnone\" width=\"166\"]\"\u015eekil<\/a> \u015eekil 10-38.<\/strong> Yuvarlak u\u00e7lu daralan frezle t\u0131rnak yuvas\u0131n\u0131n \u015fekli ve\u00adrilir. Ayn\u0131 frez daha sonra yuvan\u0131n derinle\u015ftirilmesi i\u00e7in de kullan\u0131l\u0131r.[\/caption]\r\n\r\nT\u0131rnak yuvas\u0131n\u0131n taban\u0131 uygun e\u011fime sahip olmal\u0131 ve preparasyon yeterli derinlik sergilemelidir (\u015eekil 10-39).\r\n\r\n[caption id=\"attachment_1098\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-39.<\/strong> Prepare edilen okluzal t\u0131rnak yuvas\u0131.[\/caption]\r\n\r\nYuva son \u015feklini ald\u0131ktan sonra, ye\u015fil ta\u015fla keskin kenar ve k\u00f6\u015feler yuvarlat\u0131l\u0131r ve lastikle polisaj\u0131 tamamlan\u0131r.\r\n\r\nEmbraz\u00fcr t\u0131rnak yuvas\u0131: \u0130ki kom\u015fu di\u015fin okluzal embraz\u00fcrlerini i\u00e7ine alarak, bir di\u015fin mezial fossas\u0131ndan kom\u015fu di\u015fin distal fossas\u0131na uzan\u0131r (\u015eekil 10-40).\r\n\r\n[caption id=\"attachment_1099\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-40.<\/strong> Embraz\u00fcr t\u0131rnak yuvas\u0131, kom\u015fu iki okluzal t\u0131rnak yuvas\u0131ndan olu\u015fur.[\/caption]\r\n\r\nPreparasyonu daha zor olan bir yuva \u015feklidir. Di\u015flerin vestib\u00fcl ve lingual y\u00fczeylerinde yetersiz preparasyon yap\u0131lmas\u0131 durumunda, HBP bile\u015feni bu b\u00f6lgelerde ince \u015fekillenir ve k\u0131r\u0131l\u0131r.\r\n\r\nYuvarlak u\u00e7lu ve gittik\u00e7e daralan \u015fekle sahip bir elmas frez kullan\u0131larak yuva s\u0131n\u0131rlar\u0131 olu\u015fturulur. Daha sonra ayn\u0131 frezle yuva derinli\u011fi haz\u0131rlan\u0131r (\u015eekil 10-41).\r\n\r\n[caption id=\"attachment_1100\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-41.<\/strong> Embraz\u00fcr t\u0131rnak yuvas\u0131, yuvarlak u\u00e7lu daralan elmas frezle \u015fekillendirilir. Vestib\u00fcl ve lingual y\u00f6ndeki uzant\u0131lar\u0131n\u0131n yeterli olmas\u0131na dikkat edilir.[\/caption]\r\n\r\n\u0130\u015flem s\u0131ras\u0131nda di\u015flerin kontakt alanlar\u0131 bozulmamal\u0131d\u0131r; aksi halde di\u015flerde migrasyon veya g\u0131da birikimi olu\u015fur. Ayn\u0131 frez kullan\u0131larak, t\u0131rnak yuvas\u0131n\u0131n vestib\u00fcl ve lingual uzant\u0131lar\u0131 haz\u0131rlan\u0131r. Genellikle vestib\u00fcl tarafta yeterli a\u00e7\u0131kl\u0131k olu\u015fturmak, lingual b\u00f6lgeden daha zordur. A\u00e7\u0131kl\u0131\u011f\u0131n kontrol\u00fc iki adet kro\u015fe teli yan yana kullan\u0131larak yap\u0131labilir. Kro\u015fe telleri embraz\u00fcr b\u00f6lgesine yerle\u015ftirilip, hasta di\u015flerini rahat\u00e7a okluzyona getirdi\u011finde, yeterli a\u00e7\u0131kl\u0131\u011f\u0131n sa\u011fland\u0131\u011f\u0131 g\u00f6r\u00fcl\u00fcr. T\u0131rnak yuvas\u0131n\u0131n \u015fekli ve derinli\u011fi pembe mumla da kontrol edilebilir. Prepare edilen di\u015fin \u00fczerine yerle\u015ftirilen disk \u015feklindeki pembe mum, di\u015fler okluzyona getirilerek \u015fekillendirilir. Mumun y\u00fczeyi incelenerek yuvan\u0131n \u015feklinin uygunlu\u011fu kontrol edildikten sonra kumpasla mumun yuva b\u00f6lgesindeki kal\u0131nl\u0131\u011f\u0131 \u00f6l\u00e7\u00fcl\u00fcr (\u015eekil 10-42); b\u00f6ylece yuvan\u0131n derinli\u011fi belirlenir. Embraz\u00fcr t\u0131rnak yuvas\u0131 3-3.5 mm geni\u015flik ve 1.5-2 mm derinli\u011fe sahip olmal\u0131d\u0131r. Yuvan\u0131n \u015fekli yuvarlat\u0131lm\u0131\u015f olmal\u0131 ve and\u0131rkatlar giderilmelidir. Yuva son olarak ye\u015fil ta\u015fla d\u00fczeltilir ve lastikle polisaj\u0131 tamamlan\u0131r.\r\n\r\n\r\n\r\n
\u015eekil 10-42. Embraz\u00fcr t\u0131rnak yuvas\u0131: a) Vestib\u00fcl ve lingual y\u00fczeylerinde yeterli preparasyon yap\u0131lmal\u0131d\u0131r. b) Derinli\u011fi, di\u015fler okluzyona getirilerek \u015fekillendirilen disk \u015feklindeki pembe mumla kontrol edilebilir.<\/caption>\r\n
\r\n\r\n[caption id=\"attachment_1102\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-42a[\/caption]<\/td>\r\n<\/tr>\r\n
\r\n\r\n[caption id=\"attachment_1103\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-42b[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\nSingulum (lingual) t\u0131rnak yuvas\u0131: Singulum t\u0131rnak yuvalar\u0131 \u201cV\u201d , \u201cU veya C\u201d ve \u201cd\u00fcz raf\u201d \u015feklinde farkl\u0131 tasar\u0131mlarda haz\u0131rlanabilir (\u015eekil 10-43).\r\n\r\n[caption id=\"attachment_1104\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-43.<\/strong> Farkl\u0131 tasar\u0131mdaki lingual (singulum) t\u0131rnak yuvalar\u0131 a)<\/strong> \u201cV\u201d \u015feklinde, b)<\/strong> \u201cU\u201d \u015feklinde, c)<\/strong> \u201cD\u00fcz raf\u201d \u015feklindeki
uygulama.[\/caption]\r\n\r\nT\u0131rnak yuvas\u0131n\u0131n konumu kar\u015f\u0131t di\u015fle temas noktas\u0131n\u0131n daha apikalinde olmal\u0131d\u0131r. Aksi halde protezin metal alt yap\u0131s\u0131 i\u00e7in yeterli mesafe sa\u011flanamaz. Yan y\u00fczeyleri kesim \u00f6zelli\u011fine sahip olan tersine konik frez kullan\u0131l\u0131r (\u015eekil 10-44).\r\n\r\n[caption id=\"attachment_1105\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-44.<\/strong> Singulum t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda kullan\u0131lan, yan y\u00fczeyleri kesim \u00f6zelli\u011fine sahip tersine konik frez.[\/caption]\r\n\r\nYuvan\u0131n duvarlar\u0131nda and\u0131rkat olu\u015fturulmamas\u0131 gerekir. Ye\u015fil ta\u015fla preparasyon alan\u0131 bitirilir ve lastik disk ve u\u00e7larla polisaj\u0131 tamamlan\u0131r. Yuvan\u0131n bitmi\u015f \u015fekli hafif\u00e7e yuvarlat\u0131lm\u0131\u015f ve d\u00fczg\u00fcn y\u00fczeyli olmal\u0131d\u0131r.\r\n\r\n\u201cV\u201d t\u0131rnak yuvas\u0131<\/strong>, lingualden bak\u0131ld\u0131\u011f\u0131nda bir marjinal kenardan di\u011ferine do\u011fru hilal \u015feklinde, proksimal y\u00fczden bak\u0131ld\u0131\u011f\u0131nda ise V \u015feklindedir (\u015eekil 10-45).\r\n\r\n[caption id=\"attachment_1106\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-45.<\/strong> Singulum t\u0131rnak yuvas\u0131n\u0131n a)<\/strong> lingual, b)<\/strong> proksimal y\u00fczeyden g\u00f6r\u00fcn\u00fcm\u00fc.[\/caption]\r\n\r\nFrez, lingual y\u00fczeyle hafif a\u00e7\u0131l\u0131 olacak \u015fekilde tutularak, lingual y\u00fczeyin bir taraf\u0131ndaki marjinal kenardan ba\u015flan\u0131r ve di\u011fer marjinal kenara kadar ilerletilir; b\u00f6ylece yuvaya hilal \u015fekli verilir (\u015eekil 10-46).\r\n\r\n\r\n\r\n\r\n
\u015eekil 10-46. Singulum t\u0131rnak yuvas\u0131: a) Tersine konik frezle ba\u015flayan preparasyon bir marjinal kenardan ba\u015flayarak, singulumu ge\u00e7er ve di\u011fer marjinal kenarda sonlan\u0131r. b) Proksimal, c) Lingual y\u00fczden g\u00f6r\u00fcn\u00fcm\u00fc.<\/caption>\r\n
\r\n\r\n[caption id=\"attachment_1107\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-46. a)[\/caption]<\/td>\r\n<\/tr>\r\n
\r\n\r\n[caption id=\"attachment_1108\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-46. b)[\/caption]<\/td>\r\n<\/tr>\r\n
\r\n\r\n[caption id=\"attachment_1109\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-46. c)[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n\u201cU\u201d veya \u201cC\u201d t\u0131rnak yuvas\u0131<\/strong>, belirgin singulumu olan di\u015fler i\u00e7in ge\u00e7erli geleneksel \u201cV\u201d \u015feklindeki uygulamaya alternatif bir tasar\u0131md\u0131r ve ters U veya C \u015feklinde bir t\u0131rnak yuvas\u0131d\u0131r (\u015eekil 10-47).\r\n\r\n[caption id=\"attachment_1111\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-47.<\/strong> \u201cU\u201d veya \u201cC\u201d singulum t\u0131rnak yuvas\u0131n\u0131n a)<\/strong> lingual, b)<\/strong> insizal y\u00fczeyden g\u00f6r\u00fcn\u00fcm\u00fc.[\/caption]\r\n\r\nLingual y\u00fczeyin bir taraf\u0131ndaki marjinal kenardan ba\u015flan\u0131r ve singulum seviyesine gelecek \u015fekilde apikal y\u00f6nde ilerlenir. Di\u011fer marjinal kenara do\u011fru ilerlenirken, frez insizal y\u00f6nde y\u00fckselir. Yeterli derinlik elde ederken, dentin a\u00e7\u0131\u011fa \u00e7\u0131kabildi\u011finden, mine \u00fczerinde nadiren tercih edilen bir yuva \u015feklidir.\r\n\r\n\u201cD\u00fcz raf\u201d \u015feklinde t\u0131rnak yuvas\u0131:<\/strong> Do\u011fal di\u015f yap\u0131s\u0131nda uyguland\u0131\u011f\u0131nda, en az etkili tasar\u0131md\u0131r. \u00d6zellikle, kaninlere uygulanan kronlarda haz\u0131rlanmas\u0131 tavsiye edilir.\r\n\r\n\u0130nsizal t\u0131rnak yuvas\u0131: Sadece alt anterior di\u015flerde haz\u0131rlanan insizal t\u0131rnak yuvas\u0131 genellikle proksimal y\u00fcze yak\u0131n alana yerle\u015ftirilir (\u015eekil 10-48).\r\n\r\n[caption id=\"attachment_1112\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-48.<\/strong>
\u0130nsizal t\u0131rnak yuva\u00ads\u0131n\u0131n a)<\/strong> vestib\u00fcl, b)<\/strong> lingual y\u00fczeyden g\u00f6r\u00fcn\u00fcm\u00fc.[\/caption]\r\n\r\nEstetik sak\u0131nca nedeniyle mezial tarafta yer almas\u0131 tercih edilmez.\r\n\r\n\u0130nsizal t\u0131rnak yuvas\u0131 preparasyonu alev u\u00e7lu bir elmas frezle ba\u015flat\u0131l\u0131r (\u015eekil 10-49).\r\n\r\n[caption id=\"attachment_1113\" align=\"alignnone\" width=\"286\"]\"\u015eekil<\/a> \u015eekil 10-49.<\/strong> \u0130nsizal t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda alev u\u00e7lu veya yuvarlak u\u00e7lu ince dara\u00adlan frezler kullanlabilir.[\/caption]\r\n\r\nFrez protezin giri\u015f yoluna paralel olacak \u015fekilde kullan\u0131l\u0131r (\u015eekil 10-50).\r\n\r\n[caption id=\"attachment_1114\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-50.<\/strong> \u0130nsizal t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda, alev u\u00e7lu frez giri\u015f yoluna paralel tutularak yerle\u015ftirilir.[\/caption]\r\n\r\nYuva proksimal k\u00f6\u015feden 2-3 mm uzakta ve 1.5-2 mm derinlikte olmal\u0131d\u0131r (\u015eekil 10-51).\r\n\r\n[caption id=\"attachment_1115\" align=\"alignnone\" width=\"253\"]\"\u015eekil<\/a> \u015eekil 10-51.<\/strong> \u0130nsizal t\u0131rnak yuvas\u0131, proksimal k\u00f6\u015feden 2-3 mm uzakta ve 1.5-2 mm derinlikte olmal\u0131d\u0131r.[\/caption]\r\n\r\nProtez \u00e7i\u011fneme y\u00fcklerinin etkisi alt\u0131ndayken, destek di\u015fin vestib\u00fcl y\u00f6nde hareketine engel olmak amac\u0131yla, \u00e7entik \u015feklinde haz\u0131rlanan yuva di\u015fin vestib\u00fcl y\u00fczeyine do\u011fru hafif\u00e7e geni\u015fletilir. Lingual y\u00fczeyde ise k\u00fc\u00e7\u00fck bir kanal \u015fekli verilir. Bu kanal min\u00f6r ba\u011flay\u0131c\u0131n\u0131n kal\u0131nl\u0131\u011f\u0131n\u0131 tolere eder. Yuvan\u0131n polisaj\u0131 ye\u015fil ta\u015f ve lastik kullan\u0131larak yap\u0131l\u0131r. Bitmi\u015f preparasyon d\u00fczg\u00fcn y\u00fczeylere sahip olmal\u0131 ve hastaya rahats\u0131zl\u0131k vermemelidir (\u015eekil 10-52).\r\n\r\n[caption id=\"attachment_1116\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 10-52.<\/strong> \u0130nsizal t\u0131rnak yuvas\u0131: Bitmi\u015f preparasyon d\u00fczg\u00fcn y\u00fczeylere sahip olmal\u0131 ve hastaya rahats\u0131zl\u0131k vermemelidir.[\/caption]\r\n\r\nAmalgam restorasyonda t\u0131rnak yuvas\u0131:<\/strong> \u00c7ok y\u00fczl\u00fc bir amalgam restorasyonda t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131 mine veya kron restorasyonundaki haz\u0131rl\u0131\u011fa g\u00f6re daha az tercih edilen bir durumdur.\r\n\r\nAmalgam ala\u015f\u0131m\u0131 y\u00fckler kar\u015f\u0131s\u0131nda deforme olur ve k\u0131r\u0131larak restorasyonun ba\u015far\u0131s\u0131zl\u0131\u011f\u0131 ile sonu\u00e7lan\u0131r.\r\n\r\nAmalgam restorasyonda t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131na karar verirken, geriye kalan di\u015f dokusunun miktar\u0131 ve b\u00f6lgesi, amalgam restorasyonun derinli\u011fi ve s\u0131n\u0131rlar\u0131, amalgam\u0131n k\u0131r\u0131lmaya direnci ile planlanan t\u0131rnak yuvas\u0131n\u0131n boyutu ve konumu de\u011ferlendirilir. Mevcut bir amalgam dolguda bu fakt\u00f6rlerin de\u011ferlendirilmesi a\u00e7\u0131s\u0131ndan ku\u015fku duyuldu\u011funda, restorasyon de\u011fi\u015ftirilerek yuva i\u00e7in uygun duruma getirilip; daha sonra yuva preparasyonu yap\u0131lmal\u0131d\u0131r.\r\n\r\nB\u00fcy\u00fck boyuttaki amalgam restorasyonlarda haz\u0131rlanan t\u0131rnak yuvas\u0131 genellikle ba\u015far\u0131s\u0131zl\u0131kla sonu\u00e7lan\u0131r. Bu nedenle daha k\u00fc\u00e7\u00fck hacimli olan dolgularda ve bir k\u0131sm\u0131 mine \u00fczerinde \u015fekillendirilen t\u0131rnak yuvalar\u0131 daha ba\u015far\u0131l\u0131 sonu\u00e7 verir; yuvan\u0131n tamam\u0131n\u0131n amalgam \u00fczerinde haz\u0131rlanmamas\u0131na dikkat edilir. \u0130\u015flem minede yap\u0131lana benzer.","rendered":"

Destek di\u015f haz\u0131rl\u0131klar\u0131ndan \u00f6nce, te\u015fhis modellerinin analiz edilmesi ve tahmini protez planlamas\u0131n\u0131n yap\u0131lm\u0131\u015f olmas\u0131 gerekir.
\nTe\u015fhis modellerinde, protezin giri\u015f yolu, de\u011fi\u015ftirilecek di\u015f y\u00fczeyleri ve konturlar\u0131, t\u0131rnak yuvalar\u0131 ve rehber d\u00fczlemlerin konumlar\u0131 belirlendikten sonra, destek di\u015f haz\u0131rl\u0131klar\u0131 minede veya restorasyon \u00fczerinde yap\u0131labilir.<\/p>\n

Mine y\u00fczeylerinin \u015feklini de\u011fi\u015ftirirken koruyuculuk esas oldu\u011fundan, d\u00fczenleme mine s\u0131n\u0131rlar\u0131 i\u00e7inde kalmal\u0131d\u0131r. A\u015f\u0131r\u0131 miktarda d\u00fczeltme gerektiren durumlarda veya yeterli mine kal\u0131nl\u0131\u011f\u0131 olmad\u0131\u011f\u0131nda, di\u015fin kronla restorasyonu daha uygundur. Yap\u0131lan de\u011fi\u015fikli\u011fin ard\u0131ndan, mine y\u00fczeyi ye\u015fil ta\u015fla d\u00fczeltilir ve lastikle cilalan\u0131p, flor uygulan\u0131r.
\nA\u011f\u0131z haz\u0131rl\u0131\u011f\u0131 i\u015flemi boyunca, te\u015fhis modeli analiz\u00f6r tablas\u0131nda giri\u015f yoluna uygun e\u011fimde yerle\u015ftirilmi\u015f olarak hekimin yan\u0131nda olmal\u0131d\u0131r. B\u00f6ylece elmas frez ve \u015fekil verilecek olan di\u015f y\u00fczeyi aras\u0131ndaki ili\u015fki modelden a\u011f\u0131za yans\u0131t\u0131l\u0131r (\u015eekil 10-18).<\/p>\n\n\n\n\n
\u015eekil 10-18. Rehber d\u00fczlem haz\u0131rl\u0131\u011f\u0131 a) Analiz\u00f6r tablas\u0131ndaki modelde \u015fekillendirilen di\u015f y\u00fczeyi ve frez aras\u0131ndaki ili\u015fki b) Frez ve model aras\u0131ndaki ili\u015fki, hasta a\u011fz\u0131na yans\u0131t\u0131larak yap\u0131lan preparasyon<\/caption>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-18 a)<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-18 b)<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Rehber d\u00fczlemlerin haz\u0131rlanmas\u0131<\/h3>\n

Protezin giri\u015f yoluna ve birbirlerine paralel olmas\u0131 gereken rehber d\u00fczlemler proksimal ve lingual di\u015f y\u00fczeylerinde haz\u0131rlan\u0131r. Rehber d\u00fczlem haz\u0131rl\u0131\u011f\u0131, destek di\u015flerin konumuna g\u00f6re farkl\u0131 \u015fekilde yap\u0131l\u0131r ve genellikle silindirik elmas veya karbid frez kullan\u0131l\u0131r (\u015eekil 10-19).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-19.<\/strong> Rehber d\u00fczlem haz\u0131rl\u0131\u011f\u0131nda kullan\u0131lan silindirik elmas frezler.<\/figcaption><\/figure>\n

Di\u015f destekli bo\u015fluklara kom\u015fu destek di\u015flerde<\/strong>, frez aproksimal y\u00fczeyin bukkal k\u00f6\u015fesinden lingual k\u00f6\u015fesine do\u011fru y\u00f6nlendirilerek, hafif kurvat\u00fcrl\u00fc bir rehber d\u00fczlem \u015fekillendirilir (\u015eekil 10-20).<\/p>\n\n\n\n\n
\u015eekil 10-20. Di\u015f destekli bo\u015flukta silindirik elmas frezle rehber d\u00fczlem haz\u0131rl\u0131\u011f\u0131: a) Anterior b) posterior destek di\u015fteki rehber d\u00fczlemlerin birbirlerine ve giri\u015f yoluna paralel olmas\u0131 gerekir.<\/caption>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-20. a)<\/strong> Anterior<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-20. b)<\/strong><\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Bu y\u00fczey, 2-4 mm okluzogingival y\u00fcksekli\u011fe sahip olan, okluzalden bak\u0131ld\u0131\u011f\u0131nda ise d\u00fcz bir y\u00fczey \u015feklinde olmayan bir kurvat\u00fcr olu\u015fturmal\u0131d\u0131r (\u015eekil 10-21).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-21. a)<\/strong> Di\u015f destekli bo\u015flu\u011fa kom\u015fu rehber d\u00fczlemin y\u00fcksekli\u011fi 2-4 mm\u2019dir. b)<\/strong> Haz\u0131rlanan y\u00fczey, okluzalden bak\u0131ld\u0131\u011f\u0131nda d\u00fcz de\u011fildir; aproksimal y\u00fczeyin do\u011fal kurvat\u00fcr\u00fcn\u00fc taklit eder.<\/figcaption><\/figure>\n

Serbest sonlu bo\u015fluklara kom\u015fu destek di\u015flerde<\/strong>, rehber d\u00fczlem y\u00fcksekli\u011fi biraz daha k\u0131sa, 1.5 -2 mm haz\u0131rlanarak (\u015eekil 10-22), bu y\u00fczeyle ili\u015fkili olan proksimal plak temas\u0131 azalt\u0131l\u0131r. B\u00f6ylece serbest sonlu kaidenin hareketine izin verilir ve destek di\u015fte olu\u015fabilecek devrilme hareketi azal\u0131r (\u015eekil 10-23).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-22.<\/strong> Serbest sonlu bo\u015flu\u011fa kom\u015fu rehber d\u00fczlemin y\u00fck\u00adsekli\u011fi 1.5-2 mm\u2019dir.<\/figcaption><\/figure>\n
\"\u015eekil<\/a>
\u015eekil 10-23.<\/strong> Serbest sonlu bo\u015flu\u011fa kom\u015fu rehber d\u00fczlemin y\u00fcksekli\u011finin daha az olu\u015fu, min\u00f6r ba\u011flay\u0131c\u0131 ile temas\u0131 azaltarak, protezin serbest hareketine izin verir. B\u00f6ylece destek di\u015fe iletilecek tork kuvveti azal\u0131r.<\/figcaption><\/figure>\n

Destek di\u015flerin lingual y\u00fczeylerinde<\/strong>, rehber d\u00fczlemin okluzogingival y\u00fcksekli\u011fi 2-4 mm\u2019dir. Mezial veya distal y\u00fczden bak\u0131ld\u0131\u011f\u0131nda klinik kronun orta \u00fc\u00e7l\u00fcs\u00fcnde yer al\u0131r (\u015eekil 10-24).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-24.<\/strong> Lingual rehber d\u00fczlemin okluzogingival y\u00fcksekli\u011fi 2-4 mm\u2019dir ve klinik kronun orta \u00fc\u00e7l\u00fcs\u00fcnde konumlan\u0131r.<\/figcaption><\/figure>\n

Destek di\u015fin gingival \u00fc\u00e7te bir b\u00f6lgesinin \u015feklinin de\u011fi\u015ftirilmemesine dikkat edilir; aksi halde g\u0131da birikimi nedeniyle marjinal di\u015fetinde yaralanmalar olu\u015fur.<\/p>\n

Anterior destek di\u015flerin<\/strong> eksikli\u011finde kom\u015fu di\u015fler bo\u015flu\u011fa do\u011fru devrilir veya kayar; di\u015f diziminin esteti\u011fi bozulur.<\/p>\n

Di\u015fler devrilmemi\u015f olsa bile, kontur y\u00fcksekli\u011finin alt b\u00f6l\u00fcm\u00fcnde geni\u015f bir and\u0131rkat olu\u015fur (\u015eekil 10-25).<\/p>\n\n\n\n\n
\u015eekil 10-25. Anterior di\u015f eksikli\u011finde, destek di\u015flerin (a ve b) kontur y\u00fcksekli\u011finin alt b\u00f6l\u00fcm\u00fcnde ve proksimale bakan y\u00fczeyde geni\u015f bir and\u0131rkat olu\u015fur.<\/caption>\n
\n
\"\u015eekil<\/a>
a)<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n
\n
\"\u015eekil<\/a>
b)<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Bu y\u00fczeyde yap\u0131lacak rehber d\u00fczlem de giri\u015f yoluna paralel olmal\u0131d\u0131r (\u015eekil 10-26).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-26.<\/strong> Anterior rehber d\u00fczlem preparasyonu. a) Destek di\u015fin mezial and\u0131rkat\u0131 azalt\u0131l\u0131r. b) Preparasyon sonras\u0131nda geriye kalan and\u0131rkat hareketli protez i\u00e7in daha uygun olur.<\/figcaption><\/figure>\n

De\u011fi\u015fiklik i\u00e7in gereken preparasyon mine s\u0131n\u0131rlar\u0131 i\u00e7inde kalmayacak kadar fazla olursa, di\u015fin kronla restorasyonu planlan\u0131r.<\/p>\n

Kontur y\u00fcksekli\u011finin de\u011fi\u015ftirilmesi<\/h3>\n

Kro\u015fe kolu, kronun gingival ve orta \u00fc\u00e7l\u00fcs\u00fcn\u00fcn birle\u015fim yerinden daha okluzale veya insizale do\u011fru konumlanmaz. B\u00f6ylece kro\u015fenin estetik \u00f6zelli\u011fi artar ve kro\u015fe di\u015fin rotasyon merkezine yak\u0131n b\u00f6lgesine yerle\u015ferek, mekanik avantaj da sa\u011flar. Kro\u015fe kollar\u0131n\u0131n veya lingual pla\u011f\u0131n daha uygun bir konumda yerle\u015ftirilmesi i\u00e7in kontur y\u00fcksekli\u011fi de\u011fi\u015ftirilebilir.<\/p>\n

Genelde maksiller posterior di\u015fler fasiyal y\u00f6nde, mandibular di\u015fler ise lingual y\u00f6nde devrilirler ve di\u015flerin kontur y\u00fcksekli\u011finde de\u011fi\u015fiklik olu\u015fur. Protez bile\u015fenlerinin do\u011fru yerle\u015fimini sa\u011flamak i\u00e7in, e\u011fimli bir silindirik frezle mine y\u00fczeyinde d\u00fczeltme yap\u0131l\u0131r (\u015eekil 10-27 ve 10-28).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-27.<\/strong> Kontur y\u00fcksekli\u011finin preparasyon \u00f6ncesindeki durumu.<\/figcaption><\/figure>\n
\"\u015eekil<\/a>
\u015eekil 10-28.<\/strong> Preparasyon sonras\u0131ndaki kontur y\u00fcksekli\u011fi ve ekvator hatt\u0131ndaki de\u011fi\u015fiklik.<\/figcaption><\/figure>\n

Tutucu and\u0131rkatlar\u0131n artt\u0131r\u0131lmas\u0131<\/h3>\n

Mevcut and\u0131rkat miktar\u0131n\u0131n artt\u0131r\u0131lmas\u0131 veya yeni bir and\u0131rkat olu\u015fturulmas\u0131 i\u00e7in di\u015f y\u00fczeylerinin de\u011fi\u015ftirilmesi s\u0131k uygulanan bir i\u015flem de\u011fildir. B\u00f6yle bir uygulama i\u00e7in di\u015f y\u00fczeylerinin vertikale yak\u0131n ve and\u0131rkats\u0131z bir \u015fekle sahip olmas\u0131 gerekir. Bu durumda, elmas rond frez anteroposterior y\u00f6nde hareket ettirilerek, di\u015f y\u00fczeyinde hafif bir girinti olu\u015fturulur (\u015eekil 10-29 ve 10-30).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-29. a)<\/strong> Vestib\u00fcl ve lingual y\u00fcz\u00fcnde kontur olmayan destek di\u015f, b)<\/strong> Vestib\u00fcl y\u00fczeyde preparasyonla olu\u015fturulan hafif girinti.<\/figcaption><\/figure>\n
\"\u015eekil<\/a>
\u015eekil 10-30.<\/strong> Vestib\u00fcl y\u00fczeyde anteroposterior y\u00f6nde kullan\u0131lan rond frezle hafif bir girinti \u015feklinde tutucu b\u00f6lge \u015fekillendirilir.<\/figcaption><\/figure>\n

Girintinin, gingival marjine paralel olmas\u0131; meziodistal uzunlu\u011funun ve okluzogingival y\u00fcksekli\u011finin 3 mm olmas\u0131 gerekir. Daha da \u00f6nemlisi, giri\u015f yoluyla ili\u015fkili olarak, planlanan kro\u015feye g\u00f6re de\u011fi\u015fmekle birlikte en az 0.25 mm\u2019lik and\u0131rkat derinli\u011fine sahip olmal\u0131d\u0131r. Ancak bu girintinin keskin olmamas\u0131 yumu\u015fak ge\u00e7i\u015fle yap\u0131lmas\u0131 gerekir; aksi halde kro\u015fenin and\u0131rkata yerle\u015fmesi ve uzakla\u015fmas\u0131 esnas\u0131nda sorun olu\u015fur (\u015eekil 10-31).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-31.<\/strong> Girintinin keskin k\u00f6\u015felere sahip olmamas\u0131 gerekir; aksi halde kro\u015fenin tutucu alana yerle\u015fip uzakla\u015f\u00admas\u0131 zorla\u015f\u0131r.<\/figcaption><\/figure>\n

T\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131<\/h3>\n

Okluzal t\u0131rnak yuvas\u0131: Taban\u0131 marjinal kenarda ve tepesi di\u015fin merkezinde olan \u00fc\u00e7gen \u015feklindedir. Yuvan\u0131n d\u0131\u015f kenarlar\u0131 ve \u00f6zellikle de \u00fc\u00e7genin tepesi yuvarlat\u0131lm\u0131\u015f olmal\u0131d\u0131r. Okluzal t\u0131rnak yuvas\u0131 i\u00e7in ideal geni\u015flik premolar di\u015fler i\u00e7in bukkal ve lingual t\u00fcberk\u00fcl tepelerinin aras\u0131ndaki mesafenin yakla\u015f\u0131k olarak yar\u0131s\u0131, molar di\u015fler i\u00e7in ise bundan biraz daha azd\u0131r (\u015eekil 10-32).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-32.<\/strong> Okluzal t\u0131rna\u011f\u0131n boyutu, di\u015fin t\u00fcberk\u00fcl tepeleri aras\u0131ndaki bukkolingual geni\u015fli\u011fin yar\u0131s\u0131 ve meziodistal geni\u015fli\u011finin \u00fc\u00e7te biri veya yar\u0131s\u0131 kadar olmal\u0131d\u0131r.<\/figcaption><\/figure>\n

Proteze gelen kuvvetlerin vertikal y\u00f6nde iletilebilmesi i\u00e7in, t\u0131rnak yuvas\u0131n\u0131n taban\u0131 ile di\u015fin proksimal y\u00fczeyinden, uzun aks\u0131na paralel olarak \u00e7izilen do\u011fru aras\u0131ndaki a\u00e7\u0131n\u0131n 90\u00b0\u2019den az olmas\u0131 gerekir (\u015eekil 10-33).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-33.<\/strong> T\u0131rnak yuvas\u0131n\u0131n taban\u0131 ve di\u015fin proksimal y\u00fc\u00adzeyinden di\u015fin uzun aks\u0131na paralel olarak \u00e7izilen do\u011fru aras\u0131n\u00addaki a\u00e7\u0131 90\u00b0\u2019den az olmal\u0131d\u0131r.<\/figcaption><\/figure>\n

Destek di\u015f normal konumunda oldu\u011funda, t\u0131rnak yuvas\u0131 rezid\u00fcel kret tepesinin merkezinde olmal\u0131d\u0131r; ancak bu durum rotasyona u\u011fram\u0131\u015f veya devrilmi\u015f di\u015fler i\u00e7in pratik bir yakla\u015f\u0131m de\u011fildir.<\/p>\n

A\u015f\u0131r\u0131 derecede meziale e\u011fimli mandibular molar di\u015flerde, di\u015fin mezial y\u00fczeyindeki t\u0131rnak yuvas\u0131n\u0131n taban\u0131 di\u015fin uzun aks\u0131na dik olacak \u015fekilde haz\u0131rlan\u0131r (\u015eekil 10-34).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-34.<\/strong> Meziale e\u011fimli mandibular molar di\u015fte haz\u0131r\u00adlanacak olan t\u0131rnak yuvas\u0131n\u0131n taban\u0131 di\u015fin uzun aks\u0131na dik ol\u00addu\u011funda, di\u015fin daha fazla meziale devril\u00admesi \u00f6nlenebilir.<\/figcaption><\/figure>\n

Okluzal t\u0131rna\u011f\u0131n en ince oldu\u011fu b\u00f6lgede en az 1 mm kal\u0131nl\u0131kta olmas\u0131 gerekti\u011finden t\u0131rnak yuvas\u0131n\u0131n derinli\u011fi, kar\u015f\u0131t arkla okluzal \u00e7at\u0131\u015fmaya neden olmayacak \u015fekilde haz\u0131rlan\u0131r. Ancak yuva \u00e7ok derin yap\u0131larak vertikal duvarlar olu\u015fturulmamal\u0131 ve t\u0131rna\u011f\u0131n destek di\u015fte horizontal y\u00f6nde stres olu\u015fturmas\u0131na izin verilmemelidir. K\u0131r\u0131lmaya yatk\u0131n hale gelen k\u0131sa ve korumas\u0131z mine prizmalar\u0131 b\u0131rak\u0131lmadan, yuva y\u00fczeylerinin t\u00fcm\u00fc, kro\u015fenin di\u015fe tork kuvveti iletmeden hafif derecede hareket etmesine izin verecek \u015fekilde yuvarlat\u0131l\u0131r. Keskin k\u00f6\u015felere sahip olan bir t\u0131rnak yuvas\u0131, \u00f6zellikle serbest sonlu kaidenin fonksiyon esnas\u0131ndaki hareketine izin vermez.<\/p>\n

Minesi zaten a\u015f\u0131nm\u0131\u015f ve ince bir mine tabakas\u0131 kalm\u0131\u015f olan abraze di\u015flerde t\u0131rnak yuvas\u0131n\u0131n do\u011frudan di\u015f \u00fczerinde haz\u0131rlanmas\u0131 yerine, di\u015fin kronla restorasyonu tercih edilir.<\/p>\n

Okluzal t\u0131rnak yuvas\u0131 rond frez, yuvarlak u\u00e7lu veya gittik\u00e7e daralan elmas frezlerle haz\u0131rlanabilir (\u015eekil 10-35).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-35.<\/strong> Okluzal t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda daralan silindir ve rond gibi farkl\u0131 tipte frezler kullan\u0131labilir.<\/figcaption><\/figure>\n

Rond frez kullan\u0131ld\u0131\u011f\u0131nda, yuvada and\u0131rkat olu\u015fturulmamas\u0131na dikkat edilir (\u015eekil 10-36).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-36.<\/strong> T\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda rond frez kullan\u0131l\u0131rken, and\u0131rkat olu\u015fturulmamas\u0131na dikkat edilir.
a)<\/strong> Mine y\u00fczeyinin \u00fczerinde konumland\u0131r\u0131lan rond frez.
b)<\/strong> Dikey y\u00f6nde ilerletien rond frez.
c)<\/strong> Yatay y\u00f6nde ilerletilen rond frez.
d)<\/strong> Frez kald\u0131r\u0131ld\u0131\u00ad\u011f\u0131nda olu\u015fan and\u0131rkat.<\/figcaption><\/figure>\n

Yuvarlak u\u00e7lu ve gittik\u00e7e daralan frezler and\u0131rkat olu\u015fturmadan preparasyon yapabilmeye olanak sa\u011flar (\u015eekil 10-37).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-37.<\/strong> T\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda daralan silindir frez kullan\u0131ld\u0131\u011f\u0131nda and\u0131rkat olu\u015fturma ihtimali azal\u0131r.
a)<\/strong> Mine y\u00fczeyinin \u00fczerinde konumland\u0131r\u0131lan daralan frez.
b)<\/strong> Dikey y\u00f6nde ilerletilen daralan frez.
c)<\/strong> Yatay y\u00f6nde ilerletilen daralan frez.
d)<\/strong> Frez kald\u0131r\u0131ld\u0131\u011f\u0131nda and\u0131rkat olu\u015fmamas\u0131.<\/figcaption><\/figure>\n

Se\u00e7ilen frezle \u00f6ncelikle yuvan\u0131n \u015fekli, daha sonra da ideal derinli\u011fi olu\u015fturulur (\u015eekil 10-38).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-38.<\/strong> Yuvarlak u\u00e7lu daralan frezle t\u0131rnak yuvas\u0131n\u0131n \u015fekli ve\u00adrilir. Ayn\u0131 frez daha sonra yuvan\u0131n derinle\u015ftirilmesi i\u00e7in de kullan\u0131l\u0131r.<\/figcaption><\/figure>\n

T\u0131rnak yuvas\u0131n\u0131n taban\u0131 uygun e\u011fime sahip olmal\u0131 ve preparasyon yeterli derinlik sergilemelidir (\u015eekil 10-39).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-39.<\/strong> Prepare edilen okluzal t\u0131rnak yuvas\u0131.<\/figcaption><\/figure>\n

Yuva son \u015feklini ald\u0131ktan sonra, ye\u015fil ta\u015fla keskin kenar ve k\u00f6\u015feler yuvarlat\u0131l\u0131r ve lastikle polisaj\u0131 tamamlan\u0131r.<\/p>\n

Embraz\u00fcr t\u0131rnak yuvas\u0131: \u0130ki kom\u015fu di\u015fin okluzal embraz\u00fcrlerini i\u00e7ine alarak, bir di\u015fin mezial fossas\u0131ndan kom\u015fu di\u015fin distal fossas\u0131na uzan\u0131r (\u015eekil 10-40).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-40.<\/strong> Embraz\u00fcr t\u0131rnak yuvas\u0131, kom\u015fu iki okluzal t\u0131rnak yuvas\u0131ndan olu\u015fur.<\/figcaption><\/figure>\n

Preparasyonu daha zor olan bir yuva \u015feklidir. Di\u015flerin vestib\u00fcl ve lingual y\u00fczeylerinde yetersiz preparasyon yap\u0131lmas\u0131 durumunda, HBP bile\u015feni bu b\u00f6lgelerde ince \u015fekillenir ve k\u0131r\u0131l\u0131r.<\/p>\n

Yuvarlak u\u00e7lu ve gittik\u00e7e daralan \u015fekle sahip bir elmas frez kullan\u0131larak yuva s\u0131n\u0131rlar\u0131 olu\u015fturulur. Daha sonra ayn\u0131 frezle yuva derinli\u011fi haz\u0131rlan\u0131r (\u015eekil 10-41).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-41.<\/strong> Embraz\u00fcr t\u0131rnak yuvas\u0131, yuvarlak u\u00e7lu daralan elmas frezle \u015fekillendirilir. Vestib\u00fcl ve lingual y\u00f6ndeki uzant\u0131lar\u0131n\u0131n yeterli olmas\u0131na dikkat edilir.<\/figcaption><\/figure>\n

\u0130\u015flem s\u0131ras\u0131nda di\u015flerin kontakt alanlar\u0131 bozulmamal\u0131d\u0131r; aksi halde di\u015flerde migrasyon veya g\u0131da birikimi olu\u015fur. Ayn\u0131 frez kullan\u0131larak, t\u0131rnak yuvas\u0131n\u0131n vestib\u00fcl ve lingual uzant\u0131lar\u0131 haz\u0131rlan\u0131r. Genellikle vestib\u00fcl tarafta yeterli a\u00e7\u0131kl\u0131k olu\u015fturmak, lingual b\u00f6lgeden daha zordur. A\u00e7\u0131kl\u0131\u011f\u0131n kontrol\u00fc iki adet kro\u015fe teli yan yana kullan\u0131larak yap\u0131labilir. Kro\u015fe telleri embraz\u00fcr b\u00f6lgesine yerle\u015ftirilip, hasta di\u015flerini rahat\u00e7a okluzyona getirdi\u011finde, yeterli a\u00e7\u0131kl\u0131\u011f\u0131n sa\u011fland\u0131\u011f\u0131 g\u00f6r\u00fcl\u00fcr. T\u0131rnak yuvas\u0131n\u0131n \u015fekli ve derinli\u011fi pembe mumla da kontrol edilebilir. Prepare edilen di\u015fin \u00fczerine yerle\u015ftirilen disk \u015feklindeki pembe mum, di\u015fler okluzyona getirilerek \u015fekillendirilir. Mumun y\u00fczeyi incelenerek yuvan\u0131n \u015feklinin uygunlu\u011fu kontrol edildikten sonra kumpasla mumun yuva b\u00f6lgesindeki kal\u0131nl\u0131\u011f\u0131 \u00f6l\u00e7\u00fcl\u00fcr (\u015eekil 10-42); b\u00f6ylece yuvan\u0131n derinli\u011fi belirlenir. Embraz\u00fcr t\u0131rnak yuvas\u0131 3-3.5 mm geni\u015flik ve 1.5-2 mm derinli\u011fe sahip olmal\u0131d\u0131r. Yuvan\u0131n \u015fekli yuvarlat\u0131lm\u0131\u015f olmal\u0131 ve and\u0131rkatlar giderilmelidir. Yuva son olarak ye\u015fil ta\u015fla d\u00fczeltilir ve lastikle polisaj\u0131 tamamlan\u0131r.<\/p>\n\n\n\n\n
\u015eekil 10-42. Embraz\u00fcr t\u0131rnak yuvas\u0131: a) Vestib\u00fcl ve lingual y\u00fczeylerinde yeterli preparasyon yap\u0131lmal\u0131d\u0131r. b) Derinli\u011fi, di\u015fler okluzyona getirilerek \u015fekillendirilen disk \u015feklindeki pembe mumla kontrol edilebilir.<\/caption>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-42a<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-42b<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Singulum (lingual) t\u0131rnak yuvas\u0131: Singulum t\u0131rnak yuvalar\u0131 \u201cV\u201d , \u201cU veya C\u201d ve \u201cd\u00fcz raf\u201d \u015feklinde farkl\u0131 tasar\u0131mlarda haz\u0131rlanabilir (\u015eekil 10-43).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-43.<\/strong> Farkl\u0131 tasar\u0131mdaki lingual (singulum) t\u0131rnak yuvalar\u0131 a)<\/strong> \u201cV\u201d \u015feklinde, b)<\/strong> \u201cU\u201d \u015feklinde, c)<\/strong> \u201cD\u00fcz raf\u201d \u015feklindeki
uygulama.<\/figcaption><\/figure>\n

T\u0131rnak yuvas\u0131n\u0131n konumu kar\u015f\u0131t di\u015fle temas noktas\u0131n\u0131n daha apikalinde olmal\u0131d\u0131r. Aksi halde protezin metal alt yap\u0131s\u0131 i\u00e7in yeterli mesafe sa\u011flanamaz. Yan y\u00fczeyleri kesim \u00f6zelli\u011fine sahip olan tersine konik frez kullan\u0131l\u0131r (\u015eekil 10-44).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-44.<\/strong> Singulum t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda kullan\u0131lan, yan y\u00fczeyleri kesim \u00f6zelli\u011fine sahip tersine konik frez.<\/figcaption><\/figure>\n

Yuvan\u0131n duvarlar\u0131nda and\u0131rkat olu\u015fturulmamas\u0131 gerekir. Ye\u015fil ta\u015fla preparasyon alan\u0131 bitirilir ve lastik disk ve u\u00e7larla polisaj\u0131 tamamlan\u0131r. Yuvan\u0131n bitmi\u015f \u015fekli hafif\u00e7e yuvarlat\u0131lm\u0131\u015f ve d\u00fczg\u00fcn y\u00fczeyli olmal\u0131d\u0131r.<\/p>\n

\u201cV\u201d t\u0131rnak yuvas\u0131<\/strong>, lingualden bak\u0131ld\u0131\u011f\u0131nda bir marjinal kenardan di\u011ferine do\u011fru hilal \u015feklinde, proksimal y\u00fczden bak\u0131ld\u0131\u011f\u0131nda ise V \u015feklindedir (\u015eekil 10-45).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-45.<\/strong> Singulum t\u0131rnak yuvas\u0131n\u0131n a)<\/strong> lingual, b)<\/strong> proksimal y\u00fczeyden g\u00f6r\u00fcn\u00fcm\u00fc.<\/figcaption><\/figure>\n

Frez, lingual y\u00fczeyle hafif a\u00e7\u0131l\u0131 olacak \u015fekilde tutularak, lingual y\u00fczeyin bir taraf\u0131ndaki marjinal kenardan ba\u015flan\u0131r ve di\u011fer marjinal kenara kadar ilerletilir; b\u00f6ylece yuvaya hilal \u015fekli verilir (\u015eekil 10-46).<\/p>\n\n\n\n\n\n
\u015eekil 10-46. Singulum t\u0131rnak yuvas\u0131: a) Tersine konik frezle ba\u015flayan preparasyon bir marjinal kenardan ba\u015flayarak, singulumu ge\u00e7er ve di\u011fer marjinal kenarda sonlan\u0131r. b) Proksimal, c) Lingual y\u00fczden g\u00f6r\u00fcn\u00fcm\u00fc.<\/caption>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-46. a)<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-46. b)<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n
\n
\"\u015eekil<\/a>
\u015eekil 10-46. c)<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u201cU\u201d veya \u201cC\u201d t\u0131rnak yuvas\u0131<\/strong>, belirgin singulumu olan di\u015fler i\u00e7in ge\u00e7erli geleneksel \u201cV\u201d \u015feklindeki uygulamaya alternatif bir tasar\u0131md\u0131r ve ters U veya C \u015feklinde bir t\u0131rnak yuvas\u0131d\u0131r (\u015eekil 10-47).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-47.<\/strong> \u201cU\u201d veya \u201cC\u201d singulum t\u0131rnak yuvas\u0131n\u0131n a)<\/strong> lingual, b)<\/strong> insizal y\u00fczeyden g\u00f6r\u00fcn\u00fcm\u00fc.<\/figcaption><\/figure>\n

Lingual y\u00fczeyin bir taraf\u0131ndaki marjinal kenardan ba\u015flan\u0131r ve singulum seviyesine gelecek \u015fekilde apikal y\u00f6nde ilerlenir. Di\u011fer marjinal kenara do\u011fru ilerlenirken, frez insizal y\u00f6nde y\u00fckselir. Yeterli derinlik elde ederken, dentin a\u00e7\u0131\u011fa \u00e7\u0131kabildi\u011finden, mine \u00fczerinde nadiren tercih edilen bir yuva \u015feklidir.<\/p>\n

\u201cD\u00fcz raf\u201d \u015feklinde t\u0131rnak yuvas\u0131:<\/strong> Do\u011fal di\u015f yap\u0131s\u0131nda uyguland\u0131\u011f\u0131nda, en az etkili tasar\u0131md\u0131r. \u00d6zellikle, kaninlere uygulanan kronlarda haz\u0131rlanmas\u0131 tavsiye edilir.<\/p>\n

\u0130nsizal t\u0131rnak yuvas\u0131: Sadece alt anterior di\u015flerde haz\u0131rlanan insizal t\u0131rnak yuvas\u0131 genellikle proksimal y\u00fcze yak\u0131n alana yerle\u015ftirilir (\u015eekil 10-48).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-48.<\/strong>
\u0130nsizal t\u0131rnak yuva\u00ads\u0131n\u0131n a)<\/strong> vestib\u00fcl, b)<\/strong> lingual y\u00fczeyden g\u00f6r\u00fcn\u00fcm\u00fc.<\/figcaption><\/figure>\n

Estetik sak\u0131nca nedeniyle mezial tarafta yer almas\u0131 tercih edilmez.<\/p>\n

\u0130nsizal t\u0131rnak yuvas\u0131 preparasyonu alev u\u00e7lu bir elmas frezle ba\u015flat\u0131l\u0131r (\u015eekil 10-49).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-49.<\/strong> \u0130nsizal t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda alev u\u00e7lu veya yuvarlak u\u00e7lu ince dara\u00adlan frezler kullanlabilir.<\/figcaption><\/figure>\n

Frez protezin giri\u015f yoluna paralel olacak \u015fekilde kullan\u0131l\u0131r (\u015eekil 10-50).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-50.<\/strong> \u0130nsizal t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131nda, alev u\u00e7lu frez giri\u015f yoluna paralel tutularak yerle\u015ftirilir.<\/figcaption><\/figure>\n

Yuva proksimal k\u00f6\u015feden 2-3 mm uzakta ve 1.5-2 mm derinlikte olmal\u0131d\u0131r (\u015eekil 10-51).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-51.<\/strong> \u0130nsizal t\u0131rnak yuvas\u0131, proksimal k\u00f6\u015feden 2-3 mm uzakta ve 1.5-2 mm derinlikte olmal\u0131d\u0131r.<\/figcaption><\/figure>\n

Protez \u00e7i\u011fneme y\u00fcklerinin etkisi alt\u0131ndayken, destek di\u015fin vestib\u00fcl y\u00f6nde hareketine engel olmak amac\u0131yla, \u00e7entik \u015feklinde haz\u0131rlanan yuva di\u015fin vestib\u00fcl y\u00fczeyine do\u011fru hafif\u00e7e geni\u015fletilir. Lingual y\u00fczeyde ise k\u00fc\u00e7\u00fck bir kanal \u015fekli verilir. Bu kanal min\u00f6r ba\u011flay\u0131c\u0131n\u0131n kal\u0131nl\u0131\u011f\u0131n\u0131 tolere eder. Yuvan\u0131n polisaj\u0131 ye\u015fil ta\u015f ve lastik kullan\u0131larak yap\u0131l\u0131r. Bitmi\u015f preparasyon d\u00fczg\u00fcn y\u00fczeylere sahip olmal\u0131 ve hastaya rahats\u0131zl\u0131k vermemelidir (\u015eekil 10-52).<\/p>\n

\"\u015eekil<\/a>
\u015eekil 10-52.<\/strong> \u0130nsizal t\u0131rnak yuvas\u0131: Bitmi\u015f preparasyon d\u00fczg\u00fcn y\u00fczeylere sahip olmal\u0131 ve hastaya rahats\u0131zl\u0131k vermemelidir.<\/figcaption><\/figure>\n

Amalgam restorasyonda t\u0131rnak yuvas\u0131:<\/strong> \u00c7ok y\u00fczl\u00fc bir amalgam restorasyonda t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131 mine veya kron restorasyonundaki haz\u0131rl\u0131\u011fa g\u00f6re daha az tercih edilen bir durumdur.<\/p>\n

Amalgam ala\u015f\u0131m\u0131 y\u00fckler kar\u015f\u0131s\u0131nda deforme olur ve k\u0131r\u0131larak restorasyonun ba\u015far\u0131s\u0131zl\u0131\u011f\u0131 ile sonu\u00e7lan\u0131r.<\/p>\n

Amalgam restorasyonda t\u0131rnak yuvas\u0131 haz\u0131rl\u0131\u011f\u0131na karar verirken, geriye kalan di\u015f dokusunun miktar\u0131 ve b\u00f6lgesi, amalgam restorasyonun derinli\u011fi ve s\u0131n\u0131rlar\u0131, amalgam\u0131n k\u0131r\u0131lmaya direnci ile planlanan t\u0131rnak yuvas\u0131n\u0131n boyutu ve konumu de\u011ferlendirilir. Mevcut bir amalgam dolguda bu fakt\u00f6rlerin de\u011ferlendirilmesi a\u00e7\u0131s\u0131ndan ku\u015fku duyuldu\u011funda, restorasyon de\u011fi\u015ftirilerek yuva i\u00e7in uygun duruma getirilip; daha sonra yuva preparasyonu yap\u0131lmal\u0131d\u0131r.<\/p>\n

B\u00fcy\u00fck boyuttaki amalgam restorasyonlarda haz\u0131rlanan t\u0131rnak yuvas\u0131 genellikle ba\u015far\u0131s\u0131zl\u0131kla sonu\u00e7lan\u0131r. Bu nedenle daha k\u00fc\u00e7\u00fck hacimli olan dolgularda ve bir k\u0131sm\u0131 mine \u00fczerinde \u015fekillendirilen t\u0131rnak yuvalar\u0131 daha ba\u015far\u0131l\u0131 sonu\u00e7 verir; yuvan\u0131n tamam\u0131n\u0131n amalgam \u00fczerinde haz\u0131rlanmamas\u0131na dikkat edilir. \u0130\u015flem minede yap\u0131lana benzer.<\/p>\n","protected":false},"author":3,"menu_order":5,"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-1065","chapter","type-chapter","status-publish","hentry"],"part":223,"_links":{"self":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/1065","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":11,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/1065\/revisions"}],"predecessor-version":[{"id":1250,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/1065\/revisions\/1250"}],"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\/1065\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/media?parent=1065"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapter-type?post=1065"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/contributor?post=1065"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/license?post=1065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}