{"id":973,"date":"2024-03-22T09:42:00","date_gmt":"2024-03-22T09:42:00","guid":{"rendered":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/?post_type=chapter&p=973"},"modified":"2024-03-22T10:04:35","modified_gmt":"2024-03-22T10:04:35","slug":"ana-baglayicinin-secimi","status":"publish","type":"chapter","link":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/chapter\/ana-baglayicinin-secimi\/","title":{"raw":"Ana Ba\u011flay\u0131c\u0131n\u0131n Se\u00e7imi","rendered":"Ana Ba\u011flay\u0131c\u0131n\u0131n Se\u00e7imi"},"content":{"raw":"Vakan\u0131n anatomik \u00f6zellikleri, di\u015f bo\u015fluklar\u0131n\u0131n konumu ve say\u0131s\u0131, di\u015flerin splintlenme gereklili\u011fi veya indirekt tutuculu\u011fun ana ba\u011flay\u0131c\u0131 ile sa\u011flanma ihtiyac\u0131 gibi fakt\u00f6rler g\u00f6z \u00f6n\u00fcnde tutularak, endikasyonuna uygun ana ba\u011flay\u0131c\u0131 se\u00e7ilir.\r\n

\u00dcst \u00e7ene<\/h2>\r\n
    \r\n \t
  1. Geriye kalan di\u015fler yeterli periodontal deste\u011fe sahip oldu\u011funda ve ilave doku este\u011fine ihtiya\u00e7 azald\u0131\u011f\u0131nda, palatal bant veya anteroposterior bar kullan\u0131labilir \u015eekil 8-40). Palatal bant; hasta i\u00e7in en konforlu ana ba\u011flay\u0131c\u0131d\u0131r (\u015eekil 8-40a); ancak ilateral uzun serbest sonlu di\u015fsiz bo\u015fluklar\u0131n varl\u0131\u011f\u0131nda, \u00e7ok eksenli kaide hareketleri edeniyle deforme olabilir ve kullan\u0131lmamal\u0131d\u0131r. Cl I protezler i\u00e7in en rijit ve iyomekanik a\u00e7\u0131dan en avantajl\u0131 ana ba\u011flay\u0131c\u0131 \u00e7ift damak bar\u0131d\u0131r (\u015eekil 8-40b); ancak o\u011fu hasta posterior bar\u0131 tolere edemedi\u011finden bu vakalarda ikinci se\u00e7enek U-plakt\u0131r \u015eekil 8-40c).\r\n\r\n\r\n\r\n\r\n
    \u015eekil 8-40. Doku deste\u011fi gerekli olmad\u0131\u011f\u0131nda ana ba\u011flay\u0131c\u0131 tercihleri. a) Palatal bant b) Anteroposterior bar c) U-plak<\/caption>\r\n
    \r\n\r\n[caption id=\"attachment_976\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 8-40 a) Palatal bant[\/caption]<\/td>\r\n<\/tr>\r\n
    \r\n\r\n[caption id=\"attachment_977\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 8-40 b) Anteroposterior bar[\/caption]<\/td>\r\n<\/tr>\r\n
    \r\n\r\n[caption id=\"attachment_978\" align=\"alignnone\" width=\"300\"]\"\u015eekil<\/a> \u015eekil 8-40 c) U-plak[\/caption]<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n <\/li>\r\n \t
  2. Serbest sonlu vakalarda \u00f6zellikle iki veya daha az keser di\u015f varl\u0131\u011f\u0131nda, anterior \u00f6lgede yer alan destek di\u015fler ark \u00fczerinde asimetrik yerle\u015fim g\u00f6sterdi\u011finde veya i\u015flerin periodontal sa\u011fl\u0131\u011f\u0131 zay\u0131f oldu\u011funda doku deste\u011fi ve tutuculu\u011fa daha fazla htiya\u00e7 oldu\u011fundan, tam palatal plak se\u00e7ene\u011finin kullan\u0131lmas\u0131 daha uygundur. Ancak bu urumda pla\u011f\u0131n tamam\u0131n\u0131n metal olmas\u0131 yerine sadece ruga b\u00f6lgesinin metalden, posterior ar\u0131s\u0131 ve post-dam sahas\u0131n\u0131n akrilik rezinden \u015fekillendirilmesi tutuculuk, pla\u011f\u0131n afifli\u011fi ve \u0131s\u0131y\u0131 iletmemesi a\u00e7\u0131s\u0131ndan faydal\u0131d\u0131r (Bkz. ana ba\u011flay\u0131c\u0131lar; B\u00f6l\u00fcm 5, \u015eekil -10<\/a>).<\/li>\r\n \t
  3. Uzun di\u015fsiz bo\u015flu\u011fa sahip serbest sonlu vakalarda ana ba\u011flay\u0131c\u0131n\u0131n rijitli\u011fi \u00e7ok \u00f6nemlidir; bu durumda en uygun se\u00e7enekler anteroposterior bar veya tam palatal plakt\u0131r.<\/li>\r\n \t
  4. Fulkrum hatt\u0131n\u0131n \u00f6n\u00fcnde yer alan destek di\u015f say\u0131s\u0131 az oldu\u011funda veya t\u0131rnak yerle\u015fimi i\u00e7in uygun di\u015f y\u00fczeyi mevcut olmad\u0131\u011f\u0131nda, indirekt tutuculu\u011fun ana ba\u011flay\u0131c\u0131 ile sa\u011flanmas\u0131 gerekir; bu durumda rugay\u0131 kaplayan U-plak, anteroposterior bar veya tam palatal plak kullan\u0131l\u0131r (\u015eekil 8-40c).<\/li>\r\n \t
  5. \u00d6n b\u00f6lgede di\u015fsiz bo\u015fluk s\u00f6z konusu oldu\u011funda U-plak, \u00f6n b\u00f6lgesi modifiye edilmi\u015f anteroposterior bar veya tam palatal plak uygundur. Karar verirken \u00f6nemli olan fakt\u00f6rler eksik posterior di\u015flerin say\u0131s\u0131 ve konumu, geriye kalan di\u015flerin periodontal deste\u011fi ve kar\u015f\u0131t okluzyonun tipidir.<\/li>\r\n \t
  6. Torus varl\u0131\u011f\u0131nda ve cerrahi olarak giderilemedi\u011finde anteroposterior bar veya U-plak uygun olur.<\/li>\r\n \t
  7. U-plak tercihi yap\u0131ld\u0131\u011f\u0131nda, deformasyona diren\u00e7siz oldu\u011fu, kuvvetlerin destek di\u015fler \u00fczerinde yo\u011funla\u015fmas\u0131na veya di\u015fsiz bo\u015fluklar \u00fczerine y\u00f6nlenmesine neden olaca\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmelidir.<\/li>\r\n \t
  8. Rijitli\u011fi artt\u0131rmak, lateral stresleri da\u011f\u0131tmak, indirekt tutuculu\u011fu artt\u0131rmak veya g\u0131da birikimi alanlar\u0131 olu\u015fturmamak amac\u0131yla ana ba\u011flay\u0131c\u0131n\u0131n s\u0131n\u0131rlar\u0131 di\u015flerin palatinal y\u00fczeylerine kadar uzat\u0131labilir.<\/li>\r\n<\/ol>\r\n

    Alt \u00e7ene<\/h2>\r\n
      \r\n \t
    1. Di\u015f destekli vakalarda en basit ve en konforlu ana ba\u011flay\u0131c\u0131 olan lingual bar tercih edilir.<\/li>\r\n \t
    2. Gingival marjinler ve a\u011f\u0131z taban\u0131 aras\u0131nda yeterli mesafe (6-8 mm) olmad\u0131\u011f\u0131nda lingual plak kullan\u0131l\u0131r. Geni\u015f ve opere olmayan lingual torus veya y\u00fcksek lingual frenulum varl\u0131\u011f\u0131nda da lingual plak kullan\u0131l\u0131r.<\/li>\r\n \t
    3. Anterior di\u015flerin periodontal deste\u011fi zay\u0131f oldu\u011funda ve splintleme ihtiyac\u0131 varsa yine lingual plak kullan\u0131l\u0131r. Anterior di\u015flerde diastema mevcut ise kesintili lingual plak uygundur. \u00c7ift lingual bar da kullan\u0131labilir; ancak gingival marjinler ve a\u011f\u0131z taban\u0131 aras\u0131nda yeterli mesafe (6-8 mm) olmas\u0131 gerekir.<\/li>\r\n \t
    4. Sadece anterior di\u015flerin varl\u0131\u011f\u0131nda, indirekt tutuculuk ihtiyac\u0131 sadece ana ba\u011flay\u0131c\u0131dan sa\u011flanabilece\u011fi i\u00e7in, lingual plak veya Kennedy bar\u0131 kullan\u0131m\u0131 zorunludur.<\/li>\r\n<\/ol>","rendered":"

      Vakan\u0131n anatomik \u00f6zellikleri, di\u015f bo\u015fluklar\u0131n\u0131n konumu ve say\u0131s\u0131, di\u015flerin splintlenme gereklili\u011fi veya indirekt tutuculu\u011fun ana ba\u011flay\u0131c\u0131 ile sa\u011flanma ihtiyac\u0131 gibi fakt\u00f6rler g\u00f6z \u00f6n\u00fcnde tutularak, endikasyonuna uygun ana ba\u011flay\u0131c\u0131 se\u00e7ilir.<\/p>\n

      \u00dcst \u00e7ene<\/h2>\n
        \n
      1. Geriye kalan di\u015fler yeterli periodontal deste\u011fe sahip oldu\u011funda ve ilave doku este\u011fine ihtiya\u00e7 azald\u0131\u011f\u0131nda, palatal bant veya anteroposterior bar kullan\u0131labilir \u015eekil 8-40). Palatal bant; hasta i\u00e7in en konforlu ana ba\u011flay\u0131c\u0131d\u0131r (\u015eekil 8-40a); ancak ilateral uzun serbest sonlu di\u015fsiz bo\u015fluklar\u0131n varl\u0131\u011f\u0131nda, \u00e7ok eksenli kaide hareketleri edeniyle deforme olabilir ve kullan\u0131lmamal\u0131d\u0131r. Cl I protezler i\u00e7in en rijit ve iyomekanik a\u00e7\u0131dan en avantajl\u0131 ana ba\u011flay\u0131c\u0131 \u00e7ift damak bar\u0131d\u0131r (\u015eekil 8-40b); ancak o\u011fu hasta posterior bar\u0131 tolere edemedi\u011finden bu vakalarda ikinci se\u00e7enek U-plakt\u0131r \u015eekil 8-40c).
        \n\n\n\n\n\n
        \u015eekil 8-40. Doku deste\u011fi gerekli olmad\u0131\u011f\u0131nda ana ba\u011flay\u0131c\u0131 tercihleri. a) Palatal bant b) Anteroposterior bar c) U-plak<\/caption>\n
        \n
        \"\u015eekil<\/a>
        \u015eekil 8-40 a) Palatal bant<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n
        \n
        \"\u015eekil<\/a>
        \u015eekil 8-40 b) Anteroposterior bar<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n
        \n
        \"\u015eekil<\/a>
        \u015eekil 8-40 c) U-plak<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

         <\/li>\n

      2. Serbest sonlu vakalarda \u00f6zellikle iki veya daha az keser di\u015f varl\u0131\u011f\u0131nda, anterior \u00f6lgede yer alan destek di\u015fler ark \u00fczerinde asimetrik yerle\u015fim g\u00f6sterdi\u011finde veya i\u015flerin periodontal sa\u011fl\u0131\u011f\u0131 zay\u0131f oldu\u011funda doku deste\u011fi ve tutuculu\u011fa daha fazla htiya\u00e7 oldu\u011fundan, tam palatal plak se\u00e7ene\u011finin kullan\u0131lmas\u0131 daha uygundur. Ancak bu urumda pla\u011f\u0131n tamam\u0131n\u0131n metal olmas\u0131 yerine sadece ruga b\u00f6lgesinin metalden, posterior ar\u0131s\u0131 ve post-dam sahas\u0131n\u0131n akrilik rezinden \u015fekillendirilmesi tutuculuk, pla\u011f\u0131n afifli\u011fi ve \u0131s\u0131y\u0131 iletmemesi a\u00e7\u0131s\u0131ndan faydal\u0131d\u0131r (Bkz. ana ba\u011flay\u0131c\u0131lar; B\u00f6l\u00fcm 5, \u015eekil -10<\/a>).<\/li>\n
      3. Uzun di\u015fsiz bo\u015flu\u011fa sahip serbest sonlu vakalarda ana ba\u011flay\u0131c\u0131n\u0131n rijitli\u011fi \u00e7ok \u00f6nemlidir; bu durumda en uygun se\u00e7enekler anteroposterior bar veya tam palatal plakt\u0131r.<\/li>\n
      4. Fulkrum hatt\u0131n\u0131n \u00f6n\u00fcnde yer alan destek di\u015f say\u0131s\u0131 az oldu\u011funda veya t\u0131rnak yerle\u015fimi i\u00e7in uygun di\u015f y\u00fczeyi mevcut olmad\u0131\u011f\u0131nda, indirekt tutuculu\u011fun ana ba\u011flay\u0131c\u0131 ile sa\u011flanmas\u0131 gerekir; bu durumda rugay\u0131 kaplayan U-plak, anteroposterior bar veya tam palatal plak kullan\u0131l\u0131r (\u015eekil 8-40c).<\/li>\n
      5. \u00d6n b\u00f6lgede di\u015fsiz bo\u015fluk s\u00f6z konusu oldu\u011funda U-plak, \u00f6n b\u00f6lgesi modifiye edilmi\u015f anteroposterior bar veya tam palatal plak uygundur. Karar verirken \u00f6nemli olan fakt\u00f6rler eksik posterior di\u015flerin say\u0131s\u0131 ve konumu, geriye kalan di\u015flerin periodontal deste\u011fi ve kar\u015f\u0131t okluzyonun tipidir.<\/li>\n
      6. Torus varl\u0131\u011f\u0131nda ve cerrahi olarak giderilemedi\u011finde anteroposterior bar veya U-plak uygun olur.<\/li>\n
      7. U-plak tercihi yap\u0131ld\u0131\u011f\u0131nda, deformasyona diren\u00e7siz oldu\u011fu, kuvvetlerin destek di\u015fler \u00fczerinde yo\u011funla\u015fmas\u0131na veya di\u015fsiz bo\u015fluklar \u00fczerine y\u00f6nlenmesine neden olaca\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmelidir.<\/li>\n
      8. Rijitli\u011fi artt\u0131rmak, lateral stresleri da\u011f\u0131tmak, indirekt tutuculu\u011fu artt\u0131rmak veya g\u0131da birikimi alanlar\u0131 olu\u015fturmamak amac\u0131yla ana ba\u011flay\u0131c\u0131n\u0131n s\u0131n\u0131rlar\u0131 di\u015flerin palatinal y\u00fczeylerine kadar uzat\u0131labilir.<\/li>\n<\/ol>\n

        Alt \u00e7ene<\/h2>\n
          \n
        1. Di\u015f destekli vakalarda en basit ve en konforlu ana ba\u011flay\u0131c\u0131 olan lingual bar tercih edilir.<\/li>\n
        2. Gingival marjinler ve a\u011f\u0131z taban\u0131 aras\u0131nda yeterli mesafe (6-8 mm) olmad\u0131\u011f\u0131nda lingual plak kullan\u0131l\u0131r. Geni\u015f ve opere olmayan lingual torus veya y\u00fcksek lingual frenulum varl\u0131\u011f\u0131nda da lingual plak kullan\u0131l\u0131r.<\/li>\n
        3. Anterior di\u015flerin periodontal deste\u011fi zay\u0131f oldu\u011funda ve splintleme ihtiyac\u0131 varsa yine lingual plak kullan\u0131l\u0131r. Anterior di\u015flerde diastema mevcut ise kesintili lingual plak uygundur. \u00c7ift lingual bar da kullan\u0131labilir; ancak gingival marjinler ve a\u011f\u0131z taban\u0131 aras\u0131nda yeterli mesafe (6-8 mm) olmas\u0131 gerekir.<\/li>\n
        4. Sadece anterior di\u015flerin varl\u0131\u011f\u0131nda, indirekt tutuculuk ihtiyac\u0131 sadece ana ba\u011flay\u0131c\u0131dan sa\u011flanabilece\u011fi i\u00e7in, lingual plak veya Kennedy bar\u0131 kullan\u0131m\u0131 zorunludur.<\/li>\n<\/ol>\n","protected":false},"author":3,"menu_order":24,"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-973","chapter","type-chapter","status-publish","hentry"],"part":219,"_links":{"self":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/973","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/users\/3"}],"version-history":[{"count":7,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/973\/revisions"}],"predecessor-version":[{"id":983,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapters\/973\/revisions\/983"}],"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\/973\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/media?parent=973"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/pressbooks\/v2\/chapter-type?post=973"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/contributor?post=973"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/ekitap.ankara.edu.tr\/hareketli-bolumlu-protezler\/wp-json\/wp\/v2\/license?post=973"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}