Güncel Diş Hekimliğinde Fiber Kullanımı ve Fiberle Güçlendirilmiş Restorasyonlar
Özet
Diş hekimliğinde yaklaşık 25 yıldır kullanılan fiberler, materyal içerisinde stres ve kuvvet kırıcı olarak görev yaparak restorasyonların mekanik, fiziksel ve estetik özelliklerini artırmaktadır. Geleneksel kompozitlerin yüksek strese maruz kalan geniş madde kayıplı bölgelerdeki yetersizlikleri, fiberle güçlendirilmiş kompozitlerin (FGK) güncel tedavilerde kullanımını yaygınlaştırmıştır. Diş sert dokularını taklit edebilen bu biyomimetik materyaller; tiplerine (cam, karbon, aramid, polietilen), oryantasyonlarına (tek/çift yönlü, rastgele kısa) ve monomer infiltrasyonlarına (preinfiltre/non-preinfiltre) göre sınıflandırılır. En sık tercih edilen biyouyumlu cam fiberlerin yanı sıra, leno örgü yapısıyla yüksek esneklik sunan polietilen fiberler de restoratif diş hekimliğinde, post-core yapımında, adeziv köprülerde ve splint uygulamalarında sıklıkla tercih edilmektedir. Materyalin klinik başarısını; içerikteki fiber miktarı, polimer matrisle olan adezyonu, su absorpsiyonu ve polimerizasyon büzülmesi gibi faktörler doğrudan etkilemektedir. FGK'ler, geleneksel kompozitlere kıyasla daha yüksek kırılma dayanımı sergileyerek tüberkül kırılma oranını ve marjinal sızıntıyı azaltmakta, çiğneme streslerine karşı tampon görevi görmektedir. Güncel literatürde bu materyallerin klinik ömrünü uzattığı belirtilse de, klinisyenlerin güvenle kullanabilmesi için daha fazla in vitro ve uzun dönem takipli klinik çalışmalara ihtiyaç duyulmaktadır.
Fibers, which have been used in dentistry for approximately 25 years, act as stress and force breakers within the material, thereby enhancing the mechanical, physical, and aesthetic properties of restorations. The limitations of traditional composites in high-stress areas with extensive substance loss have popularized the use of fiber-reinforced composites (FRCs) in contemporary treatments. These biomimetic materials, capable of mimicking hard dental tissues, are classified according to their fiber type (glass, carbon, aramid, polyethylene), orientation (unidirectional, bidirectional, random short), and monomer infiltration (pre-infiltrated or non-pre-infiltrated). In addition to the most frequently preferred biocompatible glass fibers, polyethylene fibers, which offer high flexibility with their leno weave structure, are widely utilized in restorative dentistry, post-core build-ups, adhesive bridges, and splinting applications. The clinical success of the material is directly influenced by factors such as the amount of fiber content, its adhesion to the polymer matrix, water absorption, and polymerization shrinkage. Compared to conventional composites, FRCs exhibit higher fracture resistance, reduce cusp fracture rates and marginal leakage, and act as a buffer against masticatory stresses. Although contemporary literature indicates that these materials extend the clinical lifespan of restorations, further in vitro studies and long-term follow-up clinical trials are required for clinicians to use them with full confidence.
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