Posterior Restorasyonlarda ‘Cusp Coverage'
Özet
Tüberkül kaplaması (cusp coverage), posterior dişlerde zayıflamış tüberküllerin direkt veya indirekt restoratif materyallerle kaplanarak dişin yapısal direncinin artırılmasını ve kırılma riskinin azaltılmasını amaçlayan bir restoratif yaklaşımdır. Posterior dişler, anterior dişlere kıyasla daha yüksek ve çok yönlü okluzal kuvvetlere maruz kaldığından, restorasyon kararlarında biyomekanik değerlendirme büyük önem taşır. Klinik olarak en belirleyici parametreler; kavite derinliği, interaksiyel dentin kaybı, kalan duvar kalınlığı, marjinal sırt bütünlüğü, mine çatlakları ve fonksiyonel yük düzeyidir. Vital dişlerde, 4 mm’den sığ kavite derinliği ve ≥1 mm duvar kalınlığı mevcutsa, tüberkül kaplamasına gerek olmaksızın direkt adeziv restorasyon yeterli olabilir. Ancak, 5 mm’yi aşan kavite derinlikleri, marjinal sırt kaybı veya çatlak varlığı durumunda, restoratif materyalden bağımsız olarak tüberkül kaplaması önerilir. Redüksiyon miktarı genellikle 1–2 mm olup, seçilen materyalin mekanik özelliklerine göre değişkenlik göstermektedir. Bu nedenle tüberkül kaplamasına yönelik kararlar, standart ölçütlere değil, her hastaya özgü klinik bulguların çok boyutlu değerlendirilmesine dayanmalıdır.
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