Protetik Diş Tedavisinde Güncel CAD/CAM Materyalleri
Özet
Günümüz diş hekimliğinde bilgisayar destekli tasarım ve üretim (CAD/CAM) teknolojisi; tedavi sürelerini kısaltıp hasta memnuniyetini ve konforunu artırırken geleneksel ölçü yöntemlerine olan ihtiyacı azaltmaktadır. Tarayıcı, yazılım ve kazıyıcı sistemlerden oluşan dijital iş akışı sayesinde, klinisyenler restorasyon süreçlerini tek seansta sonlandırabilmektedir. Ancak bu teknolojinin yüksek maliyet, subgingival marjinleri görüntüleme zorluğu ve öğrenme süreci gibi dezavantajları da bulunmaktadır. Başarılı bir protetik tedavi için endikasyona uygun materyal seçimi kritik bir öneme sahiptir. CAD/CAM sistemlerinde kullanılan güncel materyaller; metaller, kompozit rezinler, seramikler ve polimerler olmak üzere dört ana grupta sınıflandırılmaktadır. Kobalt-krom ve titanyum gibi metaller altyapı pasif uyumu için tercih edilirken; kompozit rezinler daha az büzülme ve inley/onley uygulamalarında kolaylık sunar. Estetik bölgede üstün optik özellikleriyle cam matriks seramikler (feldspatik, lityum disilikat), posterior bölgede ise yüksek mekanik dirençli polikristalin seramikler (zirkonya) öne çıkmaktadır. Ayrıca, hibrit karakterdeki rezin matriks seramikler yüksek stres absorbsiyonu sağlarken, PMMA ve PEEK gibi polimerler de geçici restorasyonlar ile protez altyapılarında düşük maliyetli ve biyouyumlu alternatifler sunmaktadır.
In contemporary dentistry, computer-aided design and manufacturing (CAD/CAM) technology shortens treatment times, increases patient satisfaction and comfort, and reduces the need for conventional impression methods. Thanks to the digital workflow consisting of scanners, software, and milling systems, clinicians can finalize restorative processes in a single session. However, this technology also possesses disadvantages such as high cost, difficulty in visualizing subgingival margins, and a demanding learning curve. Proper material selection appropriate for the indication is of critical importance for successful prosthodontic treatment. Current materials used in CAD/CAM systems are classified into four main groups: metals, composite resins, ceramics, and polymers. While metals like cobalt-chromium and titanium are preferred for framework passive fit, composite resins offer reduced shrinkage and convenience in inlay/onley applications. Glass-matrix ceramics (feldspathic, lithium disilicate) stand out in the aesthetic zone with their superior optical properties, whereas polycrystalline ceramics (zirconia) with high mechanical resistance come to the fore in the posterior region. Additionally, hybrid resin-matrix ceramics provide high stress absorption, while polymers such as PMMA and PEEK offer cost-effective, biocompatible alternatives for temporary restorations and prosthetic frameworks.
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