{"id":862,"date":"2024-03-19T12:44:45","date_gmt":"2024-03-19T12:44:45","guid":{"rendered":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/?post_type=chapter&#038;p=862"},"modified":"2024-03-20T15:27:13","modified_gmt":"2024-03-20T15:27:13","slug":"destek-bolgelerinin-belirlenmesi","status":"publish","type":"chapter","link":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/chapter\/destek-bolgelerinin-belirlenmesi\/","title":{"raw":"Destek B\u00f6lgelerinin Belirlenmesi","rendered":"Destek B\u00f6lgelerinin Belirlenmesi"},"content":{"raw":"Protezin \u00fczerine oturdu\u011fu ve dokulara do\u011fru yer de\u011fi\u015ftirmesine kar\u015f\u0131 diren\u00e7 g\u00f6sterecek olan di\u015f ve doku (mukoza) destekleri belirlenir. Di\u015f deste\u011fi t\u0131rnaklar, doku deste\u011fi ise protez kaidesiyle temin edilir.\r\n\r\n<strong>Di\u015f Deste\u011fi:<\/strong> S\u0131n\u0131flamay\u0131 belirleyen di\u015fsiz bo\u015fluklara kom\u015fu olan \u201cterminal destek\u201d di\u015fler ile modifikasyon bo\u015fluklar\u0131na kom\u015fu olan ve kar\u015f\u0131t ark deste\u011fi amac\u0131yla da kullan\u0131lan \u201csekonder destek\u201d di\u015fler mukoza deste\u011finden daha avantajl\u0131d\u0131r. Di\u015f deste\u011finin en iyi \u015fekilde elde edildi\u011fi protez bile\u015feni t\u0131rnaklard\u0131r.\r\n<h2>T\u0131rnaklar<\/h2>\r\nPlanlamada ilk yer alan protez bile\u015feni t\u0131rnaklard\u0131r. Modifikasyon alanlar\u0131 da dahil olmak \u00fczere, her di\u015fsiz bo\u015flu\u011fu \u00e7evreleyen destek di\u015f(ler)e t\u0131rnak yerle\u015ftirilir. T\u0131rnaklar\u0131n konum ve say\u0131s\u0131n\u0131 belirleyen fakt\u00f6rler;\r\n<ol>\r\n \t<li>di\u015fsiz bo\u015flu\u011fun say\u0131s\u0131,<\/li>\r\n \t<li>di\u015fsiz bo\u015flu\u011fun di\u015f destekli veya serbest sonlu olu\u015fu ve<\/li>\r\n \t<li>ana ba\u011flay\u0131c\u0131n\u0131n tipidir.<\/li>\r\n<\/ol>\r\nAna ba\u011flay\u0131c\u0131lar\u0131 desteklemek amac\u0131yla da t\u0131rnaklar\u0131n kullan\u0131lmas\u0131 gerekebilir; ilave t\u0131rnaklar ana ba\u011flay\u0131c\u0131 se\u00e7iminden sonra planlan\u0131r.\r\n<div><\/div>\r\n<h2>Okluzal t\u0131rnaklar<\/h2>\r\n<h3>Cl I ve Cl II protezler<\/h3>\r\n<ul>\r\n \t<li>Her di\u015fsiz bo\u015flu\u011fa kom\u015fu olan molar ve premolar destek di\u015fe okluzal t\u0131rnak yerle\u015ftirilir.<\/li>\r\n \t<li>Fonksiyonel kuvvetlerin di\u015flerin uzun aks\u0131 boyunca iletilmesi i\u00e7in, okluzal t\u0131rnaklar\u0131n t\u0131rnak yuvalar\u0131na yerle\u015ftirilmesi avantaj sa\u011flar.<\/li>\r\n \t<li>Okluzal t\u0131rnaklar; serbest sonlu kaidelerin varl\u0131\u011f\u0131nda, di\u015fsiz bo\u015flu\u011fa kom\u015fu olan molar\u00a0 premolar di\u015flerin meziookluzal y\u00fczeylerine yerle\u015ftirilir (\u015eekil 8-1).<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_866\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1.jpg\"><img class=\"size-medium wp-image-866\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1-300x105.jpg\" alt=\"\u015eekil 8-1. Okluzal t\u0131rnak, serbest sonlu bo\u015flu\u011fa kom\u015fu destek di\u015fin meziookluzaline yerle\u015ftirilir.\" width=\"300\" height=\"105\" \/><\/a> <strong>\u015eekil 8-1.<\/strong> Okluzal t\u0131rnak, serbest sonlu bo\u015flu\u011fa kom\u015fu destek di\u015fin meziookluzaline yerle\u015ftirilir.[\/caption]\r\n<h3>Cl III protezler<\/h3>\r\n<ul>\r\n \t<li>Okluzal t\u0131rnaklar, di\u015f destekli di\u015fsiz bo\u015fluklarda, destek di\u015flerin di\u015fsiz krete yak\u0131n olan b\u00f6lgelerine yerle\u015ftirilir (\u015eekil 8-2).<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_867\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2.jpg\"><img class=\"size-medium wp-image-867\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2-300x100.jpg\" alt=\"\u015eekil 8-2. Di\u015f destekli kaidede, okluzal t\u0131rnaklar di\u015fsiz alana kom\u015fu b\u00f6lgelere yerle\u015ftirilir.\" width=\"300\" height=\"100\" \/><\/a> <strong>\u015eekil 8-2.<\/strong> Di\u015f destekli kaidede, okluzal t\u0131rnaklar di\u015fsiz alana kom\u015fu b\u00f6lgelere yerle\u015ftirilir.[\/caption]\r\n<h3>Cl IV protezler<\/h3>\r\n<div>T\u0131rnaklar di\u015fsiz bo\u015flu\u011fa kom\u015fu destek di\u015flere ve ana ba\u011flay\u0131c\u0131n\u0131n distal deste\u011fi i\u00e7in en arka b\u00f6lgede her iki taraftaki iki destek di\u015f \u00fczerine yerle\u015ftirilir (\u015eekil 8-3).<\/div>\r\n<div>\r\n\r\n[caption id=\"attachment_868\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3.jpg\"><img class=\"size-medium wp-image-868\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3-300x188.jpg\" alt=\"\u015eekil 8-3. Di\u015fsiz bo\u015flu\u011fa kom\u015fu destek di\u015flerde ve en arka b\u00f6lgedeki destek di\u015flerde kullan\u0131lan okluzal t\u0131rnaklar.\" width=\"300\" height=\"188\" \/><\/a> <strong>\u015eekil 8-3.<\/strong> Di\u015fsiz bo\u015flu\u011fa kom\u015fu destek di\u015flerde ve en arka b\u00f6lgedeki destek di\u015flerde kullan\u0131lan okluzal t\u0131rnaklar.[\/caption]\r\n\r\n<\/div>\r\n<div>Okluzal t\u0131rna\u011f\u0131n konumu ile ilgili kurallar\u0131 bozan \u00f6zel durumlar vard\u0131r:<\/div>\r\n<div>Do\u011fal okluzal temasla \u00e7at\u0131\u015fan b\u00f6lgelere kesinlikle t\u0131rnak yerle\u015ftirilmez. Bu durumda t\u0131rnak, di\u015fin di\u011fer bir taraf\u0131na veya buna kom\u015fu olan di\u011fer bir di\u015fe kayd\u0131r\u0131l\u0131r (\u015eekil 8-4).<\/div>\r\n\r\n[caption id=\"attachment_869\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4.jpg\"><img class=\"size-medium wp-image-869\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4-300x134.jpg\" alt=\"\u015eekil 8-4. a) Birinci molar\u0131n mezial aproksimalinde kar\u015f\u0131t di\u015f y\u00fczeyiyle temas oldu\u011fundan, okluzal t\u0131rnak ayn\u0131 destek di\u015fin distaline yerle\u015ftirilir. b) Her iki destek di\u015fin mezial ve distal y\u00fczeylerinde kar\u015f\u0131t temas mevcut oldu\u011fundan, okluzal t\u0131rnaklar destek di\u015flerin lingual y\u00fczeylerine yerle\u015ftirilir.\" width=\"300\" height=\"134\" \/><\/a> <strong>\u015eekil 8-4. a)<\/strong> Birinci molar\u0131n mezial aproksimalinde kar\u015f\u0131t di\u015f y\u00fczeyiyle temas oldu\u011fundan, okluzal t\u0131rnak ayn\u0131 destek di\u015fin distaline yerle\u015ftirilir. <strong>b)<\/strong> Her iki destek di\u015fin mezial ve distal y\u00fczeylerinde kar\u015f\u0131t temas mevcut oldu\u011fundan, okluzal t\u0131rnaklar destek di\u015flerin lingual y\u00fczeylerine yerle\u015ftirilir.[\/caption]\r\n\r\nT\u00fcm di\u015fler s\u0131k\u0131 okluzal temas halindeyse, okluzal t\u0131rnak yerle\u015ftirilmesi i\u00e7in minimum preparasyon gerektirecek \u00f6zel bir b\u00f6lge bulunmaya \u00e7al\u0131\u015f\u0131l\u0131r. Ancak abraze ve mine kal\u0131nl\u0131\u011f\u0131 yeterli olmayan di\u015flerde t\u0131rnak yuvas\u0131 a\u00e7\u0131lmaz; destek di\u015fin kronla restorasyonu gerekir.\r\n<ul>\r\n \t<li>Periodontal a\u00e7\u0131dan zay\u0131f destek di\u015fler s\u00f6z konusu oldu\u011funda, okluzal t\u0131rnak kom\u015fu di\u015fe yerle\u015ftirilir (\u015eekil 8-5) veya iki destek di\u015fte ortak bir yerle\u015fim sa\u011flanarak, y\u00fck da\u011f\u0131t\u0131l\u0131r (\u015eekil 8-6).<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_870\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5.jpg\"><img class=\"size-medium wp-image-870\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5-300x135.jpg\" alt=\"\u015eekil 8-5. \u0130kinci premolar di\u015f, periodontal a\u00e7\u0131dan zay\u0131f deste\u011fe sahip oldu\u011funda, okluzal t\u0131rnak birinci premolar di\u015fe yerle\u015ftirilir.\" width=\"300\" height=\"135\" \/><\/a> <strong>\u015eekil 8-5.<\/strong> \u0130kinci premolar di\u015f, periodontal a\u00e7\u0131dan zay\u0131f deste\u011fe sahip oldu\u011funda, okluzal t\u0131rnak birinci premolar di\u015fe yerle\u015ftirilir.[\/caption]\r\n\r\n[caption id=\"attachment_871\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6.jpg\"><img class=\"size-medium wp-image-871\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6-300x140.jpg\" alt=\"\u015eekil 8-6. Birinci ve ikinci premolar di\u015fler periodontal a\u00e7\u0131dan zay\u0131f oldu\u011fundan, okluzal t\u0131rnak her iki destek di\u015fe birlikte yerle\u015ftirilerek, y\u00fck da\u011f\u0131l\u0131m\u0131 sa\u011flan\u0131r.\" width=\"300\" height=\"140\" \/><\/a> <strong>\u015eekil 8-6.<\/strong> Birinci ve ikinci premolar di\u015fler periodontal a\u00e7\u0131dan zay\u0131f oldu\u011fundan, okluzal t\u0131rnak her iki destek di\u015fe birlikte yerle\u015ftirilerek, y\u00fck da\u011f\u0131l\u0131m\u0131 sa\u011flan\u0131r.[\/caption]\r\n<h2>Singulum t\u0131rna\u011f\u0131<\/h2>\r\nT\u0131rnak, singulum \u00fczerine veya anatominin s\u0131n\u0131rlamad\u0131\u011f\u0131 durumlarda singulum yerine konulur. Singulum \u00fczerinde kar\u015f\u0131t di\u015flerle temas mevcut oldu\u011funda, t\u0131rnak bu temas noktas\u0131 ve gingival marjinin 2 mm \u00fczerindeki b\u00f6lge aras\u0131nda herhangi bir yere yerle\u015ftirilir (\u015eekil 8-7).\r\n\r\n[caption id=\"attachment_872\" align=\"alignnone\" width=\"300\"]<a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7.jpg\"><img class=\"size-medium wp-image-872\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7-300x177.jpg\" alt=\"\u015eekil 8-7. a) Alt ve \u00fcst kanin di\u015fleri aras\u0131nda temas oldu\u011funda b) Singulum t\u0131rna\u011f\u0131, bu temas noktas\u0131 ile gingival marjinin 2 mm yukar\u0131s\u0131 aras\u0131ndaki herhangi bir b\u00f6lgeye yerle\u015ftirilir.\" width=\"300\" height=\"177\" \/><\/a> <strong>\u015eekil 8-7. a)<\/strong> Alt ve \u00fcst kanin di\u015fleri aras\u0131nda temas oldu\u011funda <strong>b)<\/strong> Singulum t\u0131rna\u011f\u0131, bu temas noktas\u0131 ile gingival marjinin 2 mm yukar\u0131s\u0131 aras\u0131ndaki herhangi bir b\u00f6lgeye yerle\u015ftirilir.[\/caption]\r\n\r\nBu d\u00fczeni sa\u011flamak i\u00e7in yeterli mesafe olmad\u0131\u011f\u0131nda ise ba\u015fka bir di\u015fteki t\u0131rnak se\u00e7ene\u011fi ara\u015ft\u0131r\u0131l\u0131r veya t\u0131rnak yuvas\u0131 haz\u0131rlan\u0131r.\r\n\r\n<strong>Mukoza deste\u011fi:<\/strong> Serbest sonlu kaideler ve geni\u015f di\u015f bo\u015fluklar\u0131na sahip olan di\u015f destekli vakalarda mukoza deste\u011fi \u00f6nemlidir. Serbest sonlu protezlerde kaide b\u00fcy\u00fck oranda mukoza destekli oldu\u011fundan, m\u00fcmk\u00fcn oldu\u011fu kadar geni\u015f alan\u0131 kaplamal\u0131d\u0131r. B\u00f6ylece birim alana d\u00fc\u015fen ve terminal destek di\u015flere iletilen y\u00fck miktar\u0131 azalt\u0131l\u0131r.\r\n\r\nHareketli b\u00f6l\u00fcml\u00fc protezin tutuculu\u011fu tamamiyle kaidenin s\u0131n\u0131rlar\u0131na ba\u011fl\u0131 olmasa da sulkus anatomisinin taklit edilmesi, stabilite ve destek i\u00e7in \u00f6nemlidir. Protez kenarlar\u0131 k\u0131sa tutuldu\u011funda deste\u011fin \u00e7o\u011fu kaybedilir ve destek di\u015flere gere\u011finden fazla y\u00fck iletilir; a\u015f\u0131r\u0131 uzun oldu\u011funda ise \u00e7evre dokular kaslar\u0131n hareketi nedeniyle travmaya u\u011frar. Kas ba\u011flant\u0131lar\u0131 tutucular\u0131n etkinli\u011fini azalt\u0131r ve protez yer de\u011fi\u015ftirir.\r\n\r\n&nbsp;","rendered":"<p>Protezin \u00fczerine oturdu\u011fu ve dokulara do\u011fru yer de\u011fi\u015ftirmesine kar\u015f\u0131 diren\u00e7 g\u00f6sterecek olan di\u015f ve doku (mukoza) destekleri belirlenir. Di\u015f deste\u011fi t\u0131rnaklar, doku deste\u011fi ise protez kaidesiyle temin edilir.<\/p>\n<p><strong>Di\u015f Deste\u011fi:<\/strong> S\u0131n\u0131flamay\u0131 belirleyen di\u015fsiz bo\u015fluklara kom\u015fu olan \u201cterminal destek\u201d di\u015fler ile modifikasyon bo\u015fluklar\u0131na kom\u015fu olan ve kar\u015f\u0131t ark deste\u011fi amac\u0131yla da kullan\u0131lan \u201csekonder destek\u201d di\u015fler mukoza deste\u011finden daha avantajl\u0131d\u0131r. Di\u015f deste\u011finin en iyi \u015fekilde elde edildi\u011fi protez bile\u015feni t\u0131rnaklard\u0131r.<\/p>\n<h2>T\u0131rnaklar<\/h2>\n<p>Planlamada ilk yer alan protez bile\u015feni t\u0131rnaklard\u0131r. Modifikasyon alanlar\u0131 da dahil olmak \u00fczere, her di\u015fsiz bo\u015flu\u011fu \u00e7evreleyen destek di\u015f(ler)e t\u0131rnak yerle\u015ftirilir. T\u0131rnaklar\u0131n konum ve say\u0131s\u0131n\u0131 belirleyen fakt\u00f6rler;<\/p>\n<ol>\n<li>di\u015fsiz bo\u015flu\u011fun say\u0131s\u0131,<\/li>\n<li>di\u015fsiz bo\u015flu\u011fun di\u015f destekli veya serbest sonlu olu\u015fu ve<\/li>\n<li>ana ba\u011flay\u0131c\u0131n\u0131n tipidir.<\/li>\n<\/ol>\n<p>Ana ba\u011flay\u0131c\u0131lar\u0131 desteklemek amac\u0131yla da t\u0131rnaklar\u0131n kullan\u0131lmas\u0131 gerekebilir; ilave t\u0131rnaklar ana ba\u011flay\u0131c\u0131 se\u00e7iminden sonra planlan\u0131r.<\/p>\n<div><\/div>\n<h2>Okluzal t\u0131rnaklar<\/h2>\n<h3>Cl I ve Cl II protezler<\/h3>\n<ul>\n<li>Her di\u015fsiz bo\u015flu\u011fa kom\u015fu olan molar ve premolar destek di\u015fe okluzal t\u0131rnak yerle\u015ftirilir.<\/li>\n<li>Fonksiyonel kuvvetlerin di\u015flerin uzun aks\u0131 boyunca iletilmesi i\u00e7in, okluzal t\u0131rnaklar\u0131n t\u0131rnak yuvalar\u0131na yerle\u015ftirilmesi avantaj sa\u011flar.<\/li>\n<li>Okluzal t\u0131rnaklar; serbest sonlu kaidelerin varl\u0131\u011f\u0131nda, di\u015fsiz bo\u015flu\u011fa kom\u015fu olan molar\u00a0 premolar di\u015flerin meziookluzal y\u00fczeylerine yerle\u015ftirilir (\u015eekil 8-1).<\/li>\n<\/ul>\n<figure id=\"attachment_866\" aria-describedby=\"caption-attachment-866\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-866\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1-300x105.jpg\" alt=\"\u015eekil 8-1. Okluzal t\u0131rnak, serbest sonlu bo\u015flu\u011fa kom\u015fu destek di\u015fin meziookluzaline yerle\u015ftirilir.\" width=\"300\" height=\"105\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1-300x105.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1-65x23.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1-225x79.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1-350x123.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-1.jpg 647w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-866\" class=\"wp-caption-text\"><strong>\u015eekil 8-1.<\/strong> Okluzal t\u0131rnak, serbest sonlu bo\u015flu\u011fa kom\u015fu destek di\u015fin meziookluzaline yerle\u015ftirilir.<\/figcaption><\/figure>\n<h3>Cl III protezler<\/h3>\n<ul>\n<li>Okluzal t\u0131rnaklar, di\u015f destekli di\u015fsiz bo\u015fluklarda, destek di\u015flerin di\u015fsiz krete yak\u0131n olan b\u00f6lgelerine yerle\u015ftirilir (\u015eekil 8-2).<\/li>\n<\/ul>\n<figure id=\"attachment_867\" aria-describedby=\"caption-attachment-867\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-867\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2-300x100.jpg\" alt=\"\u015eekil 8-2. Di\u015f destekli kaidede, okluzal t\u0131rnaklar di\u015fsiz alana kom\u015fu b\u00f6lgelere yerle\u015ftirilir.\" width=\"300\" height=\"100\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2-300x100.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2-65x22.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2-225x75.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2-350x117.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-2.jpg 590w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-867\" class=\"wp-caption-text\"><strong>\u015eekil 8-2.<\/strong> Di\u015f destekli kaidede, okluzal t\u0131rnaklar di\u015fsiz alana kom\u015fu b\u00f6lgelere yerle\u015ftirilir.<\/figcaption><\/figure>\n<h3>Cl IV protezler<\/h3>\n<div>T\u0131rnaklar di\u015fsiz bo\u015flu\u011fa kom\u015fu destek di\u015flere ve ana ba\u011flay\u0131c\u0131n\u0131n distal deste\u011fi i\u00e7in en arka b\u00f6lgede her iki taraftaki iki destek di\u015f \u00fczerine yerle\u015ftirilir (\u015eekil 8-3).<\/div>\n<div>\n<figure id=\"attachment_868\" aria-describedby=\"caption-attachment-868\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-868\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3-300x188.jpg\" alt=\"\u015eekil 8-3. Di\u015fsiz bo\u015flu\u011fa kom\u015fu destek di\u015flerde ve en arka b\u00f6lgedeki destek di\u015flerde kullan\u0131lan okluzal t\u0131rnaklar.\" width=\"300\" height=\"188\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3-300x188.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3-768x481.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3-65x41.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3-225x141.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3-350x219.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-3.jpg 895w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-868\" class=\"wp-caption-text\"><strong>\u015eekil 8-3.<\/strong> Di\u015fsiz bo\u015flu\u011fa kom\u015fu destek di\u015flerde ve en arka b\u00f6lgedeki destek di\u015flerde kullan\u0131lan okluzal t\u0131rnaklar.<\/figcaption><\/figure>\n<\/div>\n<div>Okluzal t\u0131rna\u011f\u0131n konumu ile ilgili kurallar\u0131 bozan \u00f6zel durumlar vard\u0131r:<\/div>\n<div>Do\u011fal okluzal temasla \u00e7at\u0131\u015fan b\u00f6lgelere kesinlikle t\u0131rnak yerle\u015ftirilmez. Bu durumda t\u0131rnak, di\u015fin di\u011fer bir taraf\u0131na veya buna kom\u015fu olan di\u011fer bir di\u015fe kayd\u0131r\u0131l\u0131r (\u015eekil 8-4).<\/div>\n<figure id=\"attachment_869\" aria-describedby=\"caption-attachment-869\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-869\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4-300x134.jpg\" alt=\"\u015eekil 8-4. a) Birinci molar\u0131n mezial aproksimalinde kar\u015f\u0131t di\u015f y\u00fczeyiyle temas oldu\u011fundan, okluzal t\u0131rnak ayn\u0131 destek di\u015fin distaline yerle\u015ftirilir. b) Her iki destek di\u015fin mezial ve distal y\u00fczeylerinde kar\u015f\u0131t temas mevcut oldu\u011fundan, okluzal t\u0131rnaklar destek di\u015flerin lingual y\u00fczeylerine yerle\u015ftirilir.\" width=\"300\" height=\"134\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4-300x134.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4-1024x456.jpg 1024w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4-768x342.jpg 768w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4-65x29.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4-225x100.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4-350x156.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-4.jpg 1139w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-869\" class=\"wp-caption-text\"><strong>\u015eekil 8-4. a)<\/strong> Birinci molar\u0131n mezial aproksimalinde kar\u015f\u0131t di\u015f y\u00fczeyiyle temas oldu\u011fundan, okluzal t\u0131rnak ayn\u0131 destek di\u015fin distaline yerle\u015ftirilir. <strong>b)<\/strong> Her iki destek di\u015fin mezial ve distal y\u00fczeylerinde kar\u015f\u0131t temas mevcut oldu\u011fundan, okluzal t\u0131rnaklar destek di\u015flerin lingual y\u00fczeylerine yerle\u015ftirilir.<\/figcaption><\/figure>\n<p>T\u00fcm di\u015fler s\u0131k\u0131 okluzal temas halindeyse, okluzal t\u0131rnak yerle\u015ftirilmesi i\u00e7in minimum preparasyon gerektirecek \u00f6zel bir b\u00f6lge bulunmaya \u00e7al\u0131\u015f\u0131l\u0131r. Ancak abraze ve mine kal\u0131nl\u0131\u011f\u0131 yeterli olmayan di\u015flerde t\u0131rnak yuvas\u0131 a\u00e7\u0131lmaz; destek di\u015fin kronla restorasyonu gerekir.<\/p>\n<ul>\n<li>Periodontal a\u00e7\u0131dan zay\u0131f destek di\u015fler s\u00f6z konusu oldu\u011funda, okluzal t\u0131rnak kom\u015fu di\u015fe yerle\u015ftirilir (\u015eekil 8-5) veya iki destek di\u015fte ortak bir yerle\u015fim sa\u011flanarak, y\u00fck da\u011f\u0131t\u0131l\u0131r (\u015eekil 8-6).<\/li>\n<\/ul>\n<figure id=\"attachment_870\" aria-describedby=\"caption-attachment-870\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-870\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5-300x135.jpg\" alt=\"\u015eekil 8-5. \u0130kinci premolar di\u015f, periodontal a\u00e7\u0131dan zay\u0131f deste\u011fe sahip oldu\u011funda, okluzal t\u0131rnak birinci premolar di\u015fe yerle\u015ftirilir.\" width=\"300\" height=\"135\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5-300x135.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5-65x29.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5-225x101.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5-350x158.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-5.jpg 661w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-870\" class=\"wp-caption-text\"><strong>\u015eekil 8-5.<\/strong> \u0130kinci premolar di\u015f, periodontal a\u00e7\u0131dan zay\u0131f deste\u011fe sahip oldu\u011funda, okluzal t\u0131rnak birinci premolar di\u015fe yerle\u015ftirilir.<\/figcaption><\/figure>\n<figure id=\"attachment_871\" aria-describedby=\"caption-attachment-871\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-871\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6-300x140.jpg\" alt=\"\u015eekil 8-6. Birinci ve ikinci premolar di\u015fler periodontal a\u00e7\u0131dan zay\u0131f oldu\u011fundan, okluzal t\u0131rnak her iki destek di\u015fe birlikte yerle\u015ftirilerek, y\u00fck da\u011f\u0131l\u0131m\u0131 sa\u011flan\u0131r.\" width=\"300\" height=\"140\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6-300x140.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6-65x30.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6-225x105.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6-350x164.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-6.jpg 663w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-871\" class=\"wp-caption-text\"><strong>\u015eekil 8-6.<\/strong> Birinci ve ikinci premolar di\u015fler periodontal a\u00e7\u0131dan zay\u0131f oldu\u011fundan, okluzal t\u0131rnak her iki destek di\u015fe birlikte yerle\u015ftirilerek, y\u00fck da\u011f\u0131l\u0131m\u0131 sa\u011flan\u0131r.<\/figcaption><\/figure>\n<h2>Singulum t\u0131rna\u011f\u0131<\/h2>\n<p>T\u0131rnak, singulum \u00fczerine veya anatominin s\u0131n\u0131rlamad\u0131\u011f\u0131 durumlarda singulum yerine konulur. Singulum \u00fczerinde kar\u015f\u0131t di\u015flerle temas mevcut oldu\u011funda, t\u0131rnak bu temas noktas\u0131 ve gingival marjinin 2 mm \u00fczerindeki b\u00f6lge aras\u0131nda herhangi bir yere yerle\u015ftirilir (\u015eekil 8-7).<\/p>\n<figure id=\"attachment_872\" aria-describedby=\"caption-attachment-872\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-872\" src=\"http:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7-300x177.jpg\" alt=\"\u015eekil 8-7. a) Alt ve \u00fcst kanin di\u015fleri aras\u0131nda temas oldu\u011funda b) Singulum t\u0131rna\u011f\u0131, bu temas noktas\u0131 ile gingival marjinin 2 mm yukar\u0131s\u0131 aras\u0131ndaki herhangi bir b\u00f6lgeye yerle\u015ftirilir.\" width=\"300\" height=\"177\" srcset=\"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7-300x177.jpg 300w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7-65x38.jpg 65w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7-225x133.jpg 225w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7-350x207.jpg 350w, https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-content\/uploads\/sites\/25\/2024\/03\/8-7.jpg 697w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-872\" class=\"wp-caption-text\"><strong>\u015eekil 8-7. a)<\/strong> Alt ve \u00fcst kanin di\u015fleri aras\u0131nda temas oldu\u011funda <strong>b)<\/strong> Singulum t\u0131rna\u011f\u0131, bu temas noktas\u0131 ile gingival marjinin 2 mm yukar\u0131s\u0131 aras\u0131ndaki herhangi bir b\u00f6lgeye yerle\u015ftirilir.<\/figcaption><\/figure>\n<p>Bu d\u00fczeni sa\u011flamak i\u00e7in yeterli mesafe olmad\u0131\u011f\u0131nda ise ba\u015fka bir di\u015fteki t\u0131rnak se\u00e7ene\u011fi ara\u015ft\u0131r\u0131l\u0131r veya t\u0131rnak yuvas\u0131 haz\u0131rlan\u0131r.<\/p>\n<p><strong>Mukoza deste\u011fi:<\/strong> Serbest sonlu kaideler ve geni\u015f di\u015f bo\u015fluklar\u0131na sahip olan di\u015f destekli vakalarda mukoza deste\u011fi \u00f6nemlidir. Serbest sonlu protezlerde kaide b\u00fcy\u00fck oranda mukoza destekli oldu\u011fundan, m\u00fcmk\u00fcn oldu\u011fu kadar geni\u015f alan\u0131 kaplamal\u0131d\u0131r. B\u00f6ylece birim alana d\u00fc\u015fen ve terminal destek di\u015flere iletilen y\u00fck miktar\u0131 azalt\u0131l\u0131r.<\/p>\n<p>Hareketli b\u00f6l\u00fcml\u00fc protezin tutuculu\u011fu tamamiyle kaidenin s\u0131n\u0131rlar\u0131na ba\u011fl\u0131 olmasa da sulkus anatomisinin taklit edilmesi, stabilite ve destek i\u00e7in \u00f6nemlidir. Protez kenarlar\u0131 k\u0131sa tutuldu\u011funda deste\u011fin \u00e7o\u011fu kaybedilir ve destek di\u015flere gere\u011finden fazla y\u00fck iletilir; a\u015f\u0131r\u0131 uzun oldu\u011funda ise \u00e7evre dokular kaslar\u0131n hareketi nedeniyle travmaya u\u011frar. Kas ba\u011flant\u0131lar\u0131 tutucular\u0131n etkinli\u011fini azalt\u0131r ve protez yer de\u011fi\u015ftirir.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"author":3,"menu_order":20,"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-862","chapter","type-chapter","status-publish","hentry"],"part":219,"_links":{"self":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/862","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":4,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/862\/revisions"}],"predecessor-version":[{"id":898,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/862\/revisions\/898"}],"part":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/parts\/219"}],"metadata":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/862\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/media?parent=862"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapter-type?post=862"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/contributor?post=862"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/license?post=862"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}